Avaliação da saúde oral, do fluxo salivar e de componentes salivares de pacientes hipertensos sob terapia anti-hipertensiva

Abstract

Introduction: Systemic artery hypertension has a high caseness and world-wide prevalence. The impact of arterial hypertension and of the use of antihypertensives in oral health has not yet been established. Objective: this paper aimed at assessing rates for oral health, saliva flow rate and saliva composition in non-hypertensive patients and hypertensive patients taking losartan and hydrochlorothiazide. Material and methods: In order to do that, rate of decayed, missing and filled teeth (DMFT), the presence of periodontal disease, non-stimulated salivary flow rate (NSFR), stimulated salivary flow rate (SSFR) using parafilm and saliva components using Fourier Transform Infrared Spectroscopy (FTIR). The 31 participants were broken down into: non-hypertensive (n=11), hypertensive + losartan (H+L, n=11) and hypertensive + losartan with hydrochlorothiazide (H+L/H, n=9). For quantitative variables, means and standard deviations have been determined; the groups were compared using the ANOVA tests and e Tukey post-hoc test. For qualitative variables, absolute and relative frequencies were determined, together with the Fisher test, correlation of Contingency Coefficients and determination of Prevalence Ratio (PR). A 5% (p<0.05) significance level was used for the analyses. Results: The results showed that H+L and H+L/H have an increased DMFT in relation to non-hypertensive patients (p<0.05). Periodontal disease was more prevalent in people who received medication, as relative frequency in non-hypertensives was 9.1%, whereas for H+L it was 27.3% (p>0.05 and a PR of 2.997) and for H+L/H it was 55.6% (p<0,05 and a PR of 6.106). Periodontal disease was correlated to the H+L/H (Contingency Coefficient:0.450; p<0.05), however, this correlation does not occur to the H+L (p>0.05). There were no statistical differences (p > 0.05) in NSFR, in SSFR and in saliva composition of components determined via ISFT. Conclusion: The hypertensive patients treated with losartan and losartan/hydrochlorothiazide have a higher DMFT rate, a lower rate of salutary teeth and greater prevalence of periodontal disease than non-hypertensive individuals. The association of hydrochlorothiazide did not provide for additional changes in oral health when compared to monotherapy using losartan. Changes in oral health were not correlated with saliva flow rate and composition, which indicates that other factors must be responsible for these chances in oral health.