Hypertension is a common major systemic disease and 1 of the most significant causes
of mortality worldwide. Persistent hypertension is 1 of the risk factors for stroke,
heart attack, heart failure, and arterial aneurysm and is a leading cause of chronic
kidney failure. Common medications used to treat hypertension include beta blockers,
angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium
channel blockers. The purpose of this study was to assess the prevalence of periapical
abscesses in patients with different types of hypertension conditions and to evaluate
the effect of commonly used antihypertensive medications on the prevalence of periapical
The integrated data of hospital patients were used. Data from the corresponding diagnosis
codes for hypertensive conditions and periapical abscess were retrieved by searching
the appropriate query in the database. The odds ratio (OR) of periapical abscesses,
its association with hypertensive conditions, and the intake of 4 antihypertensive
medications were calculated and analyzed statistically.
The prevalence of periapical abscesses in patients with hypertensive conditions was 1.2% compared
with 0.558% in the general patient population of the hospital. The OR for the prevalence
of periapical lesions in patients with hypertension was 2.32. For primary hypertension,
the OR was 2.02; for hypertensive heart disease, the OR was 2.68; for hypertensive
chronic kidney disease, the OR was 2.1; for hypertensive heart and chronic kidney
diseases, the OR was 4.16; for secondary hypertension, the OR was 4.16; and for hypertension
crisis, the OR was 5.64. For patients treated with beta blockers, the OR was 2.58;
for patients treated with angiotensin-converting enzyme inhibitors, the OR was 2.73;
for patients treated with angiotensin II receptor blockers, the OR was 1.93; and for
patients treated with calcium channel blockers, the OR was 2.79. The differences were
statistically significant (P < .0001). The OR for the prevalence of periapical abscesses in patients treated with angiotensin
II receptor blockers was significantly lower than that of patients treated with either
beta blockers or calcium channel blockers (P < .00001).
Under the conditions of this study, it appears that the prevalence of perapical abscesses
is significantly higher in hypertensive patients. The prevalence of periapical abscesses
is higher in patients with secondary hypertension than in those with primary hypertension.
Angiotensin II receptor blockers may significantly lower the prevalence of periapical
abscesses in hypertensive patients.