3.1.2. Hypertension

Hypertension is one of the most important risk factors of premature cardiovascular disease, including CKD. A systematic review has shown the relationship between periodontal disease and hypertension [59]. As stated above, inflammation in response to bacteremia or inflammatory mediators from periodontal lesions plays a role in hypertension. Possible pathophysiological mechanisms in periodontal disease and high blood pressure are endothelial dysfunction, reduction of nitric oxide bioavailability, oxidative stress, renin-angiotensin-aldosterone system activation, arterial sti ffness, and atherosclerosis [47]. Conversely, cross-sectional clinical studies have shown that risk factors for CKD in patients with periodontal disease include diabetes [60,61] and hypertension [60].
