To study the related factors of elevated blood pressure in patients with periodontitis and hypertension during supragingival surgery and further analyze the specific reasons.

Newly diagnosed patients with chronic periodontitis and essential hypertension who visited the periodontal clinic of Qingdao Stomatological Hospital from January to November 2019 were collected and their blood pressure at systolic blood pressure (SBP) were under controlled through oral antihypertensive drugs in the morning. 212 patients with 159 mmHg or diastolic blood pressure (DBP) below 99 mmHg were enrolled. The changes of blood pressure before and during the operation of ultrasound supragingival cleansing were analyzed and compared. The patients were classified into two groups: one group with blood pressure increase and the other group without significant increased according to the increase in blood pressure (DBP fluctuation ≥4 mmHg) during the operation compared with the preoperative blood pressure. The relationship between blood pressure changes and clinical factors such as gender, age, heart rate (HR) , emotional stress, morning/afternoon (AM/PM) between the two groups were analyzed and multivariate logistic regression analysis was applied.

In patients with periodontitis and hypertension, the systolic and diastolic blood pressures during the ultrasound supragingival surgery, and the heart rate were significantly higher than those before the surgery [SBP_{Intraoperative} = (133.1 ± 15.0) mmHg, SBP_Preoperative = (129.7 ± 13.4) mmHg, DBP_{Intraoperative} = (87.7 ± 10.9) mmHg, DBP_Preoperative = (83.6 ± 9.6) mmHg, HR _{Intraoperative} = (77.4 ± 11.3) beats/min, HR_Preoperative = (74.2 ± 9.9) beats/min], and the differences were statistically significant (P<0.05) . The comparison of clinical factors between the two groups showed statistically significant difference at age (t = 2.49, P = 0.013) , emotional stress (χ² = 16.27, P<0.001) , visit time (AM/PM) (χ² = 5.87, P<0.001) , while the gender factor without statistically significant difference (t = 1.78, P = 0.181) . The results of multivariate logistic regression analysis showed that the age (OR = 1.033, 95% CI = 1.001-1.065) and increased heart rate (OR = 4.073, 95% CI = 2.165) of patients with periodontitis and hypertension during the ultrasonic cleansing procedure (OR = 4.073, 95% CI = 2.165-7.661) , emotional/mental stress (OR = 4.260, 95% CI = 2.226-8.152) , and afternoon visits (PM) (OR = 2.376, 95% CI = 1.242-4.545) are all related factors for increased blood pressure during surgery (P<0.05) .

The elevation of blood pressure in patients with periodontitis and hypertension during the supragingival scaling are closely related to age, heart rate, emotional tension and treatment time (AM/PM) , which is worthy of clinical attention.