Elsevier

Dental Abstracts

Volume 62, Issue 4, July–August 2017, Pages 213-215
Dental Abstracts

Hands On
Hypertension

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Background

Hypertension, known as the ‘silent killer,’ is responsible for more than 7 million deaths each year and is a leading risk factor for death related to cardiovascular disease. Many cases of hypertension are undiagnosed until the patient develops severe disease. Oral health care practitioners need to understand the prevention, management, and treatment approaches for hypertensive patients and ways to improve patient care and outcomes in the dental office.

Hypertension Facts

Hypertension is defined as systolic blood pressure (SBP) of 140 mm Hg or diastolic blood pressure (DBP) of 90 mm Hg or greater, or taking antihypertensive medication to manage hypertension (elevated blood pressure on at least two occasions without cause). If there are no identifiable causative factors for the high blood pressure, the condition is considered essential or primary hypertension; this accounts for about 90% to 95% of all cases. Hypertension with an identifiable cause is labeled

Implications for Dental Care

Oral health care providers should understand the potential risks and complications related to a diagnosis of hypertension and treatment for the condition. The side effects of the drugs used for hypertension can be mild or absent, but may also involve life-threatening conditions. It is appropriate for the dentist to work with the patient’s medical care provider to manage the situations that may prove challenging in a dental setting (Table 5).

Routine and surgical procedures in the dental office

Special Considerations

Dentists should be aware that African Americans have the highest prevalence of hypertension in the world, significantly higher than among Caucasian or Mexican American individuals. African Americans develop hypertension earlier in life and have higher blood pressure values than Caucasians, resulting in a 1.3-times greater rate of nonfatal stroke, a 1.8-times greater rate of fatal stroke, a 1.5-times greater rate of death attributable to hemodialysis, and a 4.2-times greater rate of end-stage

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Southerland JH, Gill DG, Gangula PR, et al: Dental management in patients with hypertension: Challenges and solutions. Clin Cosmet Investig Dent 8:111-120, 2016

Reprints available from JH Southerland, Dept of Oral and Maxillofacial Surgery, Meharry Medical College, 1005 Dr DB Todd Blvd, Nashville, TN 37208; fax: +1 615 327 5722; e-mail: [email protected]

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