Oral Bacteria and Risk for Hypertension in Postmenopausal Women

A study was conducted to examine the relationship between oral mircobiota, blood pressure, and incident hypertension in postmenopausal women.

Specific oral bacteria are associated with baseline blood pressure (BP) status and the risk for incident hypertension in postmenopausal women. These findings were published in the Journal of the American Heart Association.

The analysis included 1215 postmenopausal women who were enrolled in the Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) study from 1997 to 2001, which is ancillary to the Women’s Health Initiative Observational Study (WHIOS). Eligible participants had complete information available regarding the oral subgingival plaque microbiome, baseline hypertension status and BP measurements, and annual follow-up for incident hypertension.

The women were categorized in the following groups: normotensive (systolic BP <120 mm Hg and diastolic BP <80 mm Hg; not using BP medication; no history of physician-diagnosed hypertension; mean age, 64.5 years); undiagnosed elevated BP (systolic BP ≥120 mm Hg or diastolic BP ≥80 mm Hg; no BP medication; no history of physician-diagnosed hypertension; mean age, 67.5 years); and prevalent diagnosed and treated hypertension (history of physician-diagnosed hypertension with BP medication use at WHIOS enrollment, before or at OsteoPerio study examination; mean age, 68.1 years).

The investigators identified 245 bacterial species in the subgingival plaque samples and observed significant differences (corrected P <.05) for 47 species-level operational taxonomic units in participants from the baseline BP categories.

Among 735 women without diagnosed hypertension at baseline, 52.7% developed incident physician-diagnosed hypertension treated with medication. These patients were observed after a mean follow-up of 10.4±5.9 years (range, 0.4-19.2 years).

A total of 15 baseline bacterial species were significantly associated with risk for incident hypertension, of which 10 were associated with greater hypertension risk with age-adjusted hazard ratios (HRs) of 1.10 to 1.16. These species were Streptococcus anginosus, Streptococcus salivarius, Fretibacterium sp. oral taxon 362, Selenomonas infelix, Prevotella sp. oral taxon 526, Prevotella sp. oral taxon 292, Megasphaera sp. oral taxon 123, Capnocytophaga sp. oral taxon 903, Prevotella sp. oral taxon 376, and Streptococcus lactarius.

In addition, 5 species were associated with a reduced risk for hypertension, with age-adjusted HRs of 0.82 to 0.91. These species were Neisseria subflava, Bergeyella sp. oral taxon 907, Gemella morbillorum, Leptotrichia sp. oral taxon 212, and Aggregatibacter segnis.

In multivariable adjusted analysis, 13 of the associations remained significant. Similar patterns were observed when the analysis was limited to women who were normotensive and not using BP medication at baseline. Associations were similar after stratification based on age, smoking status, BP level, and body mass index.

Study limitations include sampling subgingival plaque on only a portion of teeth that were not selected according to periodontal disease severity, which may have resulted in a lower abundance of bacteria species that could be relevant to BP. In addition, the population included only postmenopausal women.

“Given the extensive burden of hypertension presently among older adults and its expected growth in coming decades with population aging, if proven causal, associations between oral bacteria and blood pressure dysregulation might offer new opportunities for targeted clinical intervention aimed at preventing hypertension in later life,” the researchers noted.


LaMonte MJ, Gordon JH, Diaz-Moreno P, et al. Oral microbiome is associated with incident hypertension among postmenopausal women. J Am Heart Assoc. Published online March 2, 2022. doi: 10.1161/JAHA.121.021930