Association Of Elevated C-Reactive Protein With Severe Periodontitis In Hypertensive Patients In Lagos, Nigeria: A Pilot Study

Background: Epidemiological studies have shown that individuals with chronic periodontitis have a significantly higher risk of developing cardiovascular complications, which might be attributed to the increased production of inflammatory cytokines initiated by the complex microbiota in dental biofilm. Aim: The study aims to evaluate the association between chronic periodontitis and C-reactive protein (CRP) levels in a group of hypertensive individuals in Nigeria. Materials and Methods: The investigator enrolled 50 hypertensive patients with chronic periodontitis into the study from the medical outpatient clinic of a teaching hospital in Lagos, Nigeria. Full-mouth periodontal examination was done to assess the participant's periodontal status, with probing depths and clinical attachment levels of six sites on all teeth. The investigator defined periodontitis as at least one interproximal site with probing depth >= 4 mm. Classification of participants into three groups was done based on their severity of periodontitis; mild (n = 16), moderate (n = 27), and severe (n = 7) periodontitis. Their CRP serum levels were measured, and the association with the severity of periodontitis was determined. P was found to be <= 0.05. Results: The median CRP levels were 1.0 (0.6, 2.2), 2.4 (1.1, 4.8), and 4.1 mg/L (3.3, 9.4) for mild, moderate, and severe chronic periodontitis, respectively. The association between the serum CRP levels and severity of periodontitis was statistically significant (P = 0.006). Conclusion: There was an association of elevated serum CRP level with increased severity of chronic periodontitis in hypertensive individuals. This preliminary finding among Nigerians suggests that chronic periodontal inflammation may contribute to systemic inflammatory burden in hypertensive patients.