Lessons From Hypertension

Research shows that older Americans taking medication for blood pressure and for another chronic disease, mood disorder, have more root decay (Chart 1). (That’s why the Partners in Prevention risk assessment form asks about multiple medication use.)

Source: Singh ML, Papas A, Biesbrock A. 2006. Root Caries Increment in A Medication Induced Saliva Hypofunction Population, IADR Abstract 1472

Seventy-eight million Americans have hypertension. In 2012, 48% had this chronic, symptomless condition under control with medication and lifestyle changes. That is up from 29% in 2000, an increase of 66% in patient compliance in twelve years. This increase must rank as one of the most important achievements in public health.

But that means that 52% of Americans aren’t managing their high blood pressure. Why?

• 20% don’t know they have this condition. They rarely see the doctor.
• Of the 80% who are aware they have high blood pressure, some don’t take it seriously, some have side effects to medication and some don’t want to change their lifestyle (obesity, lack of exercise, too much salt in the diet). Some also take the wrong drugs or take the proper drugs wrongly.

The remarkable growth in managing hypertension over the past 10 years comes from two directions: a focus from the medical community on compliance and education, and better treatment regimens, and; the new healthcare consumer who how has a much better access to timely information on this disorder and its ramifications. Such improvement in public health has to involve both the provider and the patient.

So what are the lessons from hypertension for the improved management of adult dental decay, a disease which is as common as hypertension and which now has an effective preventive management tool called Prevora?

• The dental team and the high risk patient must both be involved.
• Medical science is adopted quickly and to great effect, particularly with the Internet and with healthcare reform
•  Almost half of high risk patients will pursue better care
• There is a growing number of older patients taking antihypertensive medication. The average Canadian senior takes 3 medications daily, so Chart 1 is increasingly relevant to the family practice.

Ross Perry