Relationship between dry mouth and hypertension

Clinical Oral Investigations (2021)Cite this article

Abstract

Objectives

Salivary dysfunction, such as reduced salivary flow and an altered salivary composition, is caused by several diseases, medical conditions, and medications. The purpose of the present study was to clarify the relationship between hypertension and morphological changes in the submandibular glands.

Materials and methods

An epidemiological study was conducted to elucidate the relationship between hypertension and dry mouth. The effects of hypertension on morphological changes and the intima thickness of arteries in the submandibular glands were histopathologically investigated.

Results

Among 1933 subjects in the epidemiological study, 155 (8.0%) had dry mouth. A multivariate analysis revealed that dry mouth correlated with age (p < 0.001), sex (p < 0.001), and hypertension (p < 0.05). No significant differences were observed in the size of the submandibular glands between patients with or without hypertension. The average area of acinar cells was smaller in patients with than in those without hypertension (0.366 ± 0.153 vs. 0.465 ± 0.178, p < 0.05). The arteriosclerotic index was significantly higher in patients with than in those without hypertension (0.304 ± 0.034 vs 0.475 ± 0.053, p < 0.05).

Conclusions

Hypertension may contribute to the degeneration of the submandibular glands by decreasing the number of acinar cells and promoting fatty infiltration and stenosis of the arteries.

Clinical relevance

There may be a correlation between hypertension and the degeneration of the submandibular glands by decreasing the number of acinar cells and promoting fatty infiltration and stenosis of the arteries.

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Abbreviations

MetS:

Metabolic syndrome

HDL-C:

High-density lipoprotein cholesterol

HbA1c:

Hemoglobin A1c

eGFR:

Estimated glomerular filtration rate

MRI:

Magnetic resonance imaging

AI:

Arteriosclerosis index

OR:

Odds ratio

CI:

Confidence interval

References

  1. 1.

    von Bültzingslöwen I, Sollecito TP, Fox PC, Daniels T, Jonsson R, Lockhart PB, Wray D, Brennan MT, Carrozzo M, Gandera B, Fujibayashi T, Navazesh M, Rhodus NL, Schiødt M (2007) Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103(Suppl):S57.e1–S57.15

    Google Scholar 

  2. 2.

    Jensen SB, Pedersen AM, Vissink A, Andersen E, Brown CG, Davies AN, Dutilh J, Fulton JS, Jankovic L, Lopes NN, Mello AL, Muniz LV, Murdoch-Kinch CA, Nair RG, Napeñas JJ, Nogueira-Rodrigues A, Saunders D, Stirling B, von Bültzingslöwen I, Weikel DS, Elting LS, Spijkervet FK, Brennan MT, Salivary Gland Hypofunction/Xerostomia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) (2010) A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 18(8):1039–1060

    Article  Google Scholar 

  3. 3.

    Nonzee V, Manopatanakul S, Khovidhunkit SO (2012) Xerostomia, hyposalivation and oral microbiota in patients using antihypertensive medications. J Med Assoc Thail 95(1):96–104

    Google Scholar 

  4. 4.

    Wolff A, Joshi RK, Ekström J, Aframian D, Pedersen AM, Proctor G, Narayana N, Villa A, Sia YW, Aliko A, McGowan R, Kerr AR, Jensen SB, Vissink A, Dawes C (2017) A guide to medications inducing salivary gland dysfunction, xerostomia, and subjective sialorrhea: a systematic review sponsored by the world workshop on oral medicine VI. Drugs R D 17(1):1–28

    Article  Google Scholar 

  5. 5.

    Egan BM, Zhao Y, Axon RN (2010) US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 303(20):2043–2050

    Article  Google Scholar 

  6. 6.

    Mitchell GF (2014) Arterial stiffness and hypertension. Hypertension 64(1):13–18

    Article  Google Scholar 

  7. 7.

    Kaess BM, Rong J, Larson MG, Hamburg NM, Vita JA, Levy D, Benjamin EJ, Vasan RS, Mitchell GF (2012) Aortic stiffness, blood pressure progression, and incident hypertension. JAMA 308(9):875–881

    Article  Google Scholar 

  8. 8.

    AlGhatrif M, Strait JB, Morrell CH, Canepa M, Wright J, Elango P, Scuteri A, Najjar SS, Ferrucci L, Lakatta EG (2013) Longitudinal trajectories of arterial stiffness and the role of blood pressure: the Baltimore Longitudinal Study of Aging. Hypertension 62(5):934–941

    Article  Google Scholar 

  9. 9.

    Tomiyama H, Townsend RR, Matsumoto C, Kimura K, Odaira M, Yoshida M, Shiina K, Yamashina A (2014) Arterial stiffness/central hemodynamics, renal function, and development of hypertension over the short term. J Hypertens 32(1):90–99

    Article  Google Scholar 

  10. 10.

    Heagerty AM, Heerkens EH, Izzard AS (2010) Small artery structure and function in hypertension. J Cell Mol Med 14(5):1037–1043

    PubMed  PubMed Central  Google Scholar 

  11. 11.

    Laurent S, Boutouyrie P (2015) The structural factor of hypertension: large and small artery alterations. Circ Res 116(6):1007–1021

    Article  Google Scholar 

  12. 12.

    Streckfus CF (1995) Salivary function and hypertension: a review of the literature and a case report. J Am Dent Assoc 126(7):1012–1017

    Article  Google Scholar 

  13. 13.

    Böhm R, van Baak M, van Hooff M, Moy J, Rahn KH (1985) Salivary flow in borderline hypertension. Klin Wochenschr 63(Suppl 3):154–156

    PubMed  Google Scholar 

  14. 14.

    Beppu M (1970) Histologic study on the change with age in common carotid artery, external carotid artery and lingual artery. J Kurume Med Assoc 33:85–110 (in Japanese with English abstract)

    Google Scholar 

  15. 15.

    Dreizen S, Levy BM, Stern MH, Bernick S (1974) Human lingual atherosclerosis. Arch Oral Biol 19(9):813–816

    Article  Google Scholar 

  16. 16.

    Macleod RI, Soames JV (1988) A morphometric study of age changes in the human lingual artery. Arch Oral Biol 33(6):455–457

    Article  Google Scholar 

  17. 17.

    Satoh M, Morita H, Suzuki A (1988) Histometrical study of intimal thickening of the human tongue arteries: aging and underlying diseases. J Jpn Stomatrol Soc 37:143–150 (in Japanese with English abstract)

    Google Scholar 

  18. 18.

    Semba I (1989) A histometrical analysis of age changes in the human lingual artery. Arch Oral Biol 34(7):483–489

    Article  Google Scholar 

  19. 19.

    Semba I, Funakoshi K, Kitano M (2001) Histomorphometric analysis of age changes in the human inferior alveolar artery. Arch Oral Biol 46(1):13–21

    Article  Google Scholar 

  20. 20.

    Ishikawa A, Tanaka M, Ogawa T, Takagi M (2003) Histometrical study of age changes of the arteries in autopsied submandibular glands, and relation with age changes of the glands. Oral Med Pathol 8(4):105–115

    Article  Google Scholar 

  21. 21.

    Waterhouse JP, Chisholm DM, Winter RB, Patel M, Yale RS (1973) Replacement of functional parenchymal cells by fat and connective tissue in human submandibular salivary glands: an age-related change. J Oral Pathol 2(1):16–27

    Article  Google Scholar 

  22. 22.

    Scott J (1975) Age, sex and contralateral differences in the volumes of human submandibular salivary glands. Arch Oral Biol 20(12):885–887

    Article  Google Scholar 

  23. 23.

    Scott J (1977) Quantitative age changes in the histological structure of human submandibular salivary glands. Arch Oral Biol 22(3):221–227

    Article  Google Scholar 

  24. 24.

    Scott J (1977) A morphometric study of age changes in the histology of the ducts of human submandibular salivary glands. Arch Oral Biol 22(4):243–249

    Article  Google Scholar 

  25. 25.

    Ministry of Health, Labour and Welfare. Specific Health checkup and Specific Health Guidance. https://www.mhlw.go.jp/english/wp/wp-hw3/dl/2-007.pdf. Accessed 14 Apr 2020

  26. 26.

    Kakinoki Y, Maki Y, Ogasawara T, Koseki T, Nishihara T, Kikutani T, Ueda K, Watanabe S, Kishimoto E (2008) Guideline for diagnosis of dry mouth in the disabled. Jpn Dent Sci Rev 27:30–34 (In Japanese)

    Google Scholar 

  27. 27.

    Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675

    Article  Google Scholar 

  28. 28.

    Niklander S, Veas L, Barrera C, Fuentes F, Chiappini G, Marshall M (2017) Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz Oral Res 31:e14

    Article  Google Scholar 

  29. 29.

    Tan ECK, Lexomboon D, Sandborgh-Englund G, Haasum Y, Johnell K (2018) Medications that cause dry mouth as an adverse effect in older people: a systematic review and metaanalysis. J Am Geriatr Soc 66(1):76–84

    Article  Google Scholar 

  30. 30.

    Martinez-Madrigal F, Micheau C (1989) Histology of the major salivary glands. Am J Surg Pathol 13(10):879–899

    Article  Google Scholar 

  31. 31.

    Nobuyuki Bill Miyawaki and Paula E. Lester. Chapter 13: Vascular disease in the elderly, Geriatric Nephrology Curriculum, American Society of Nephrology, https://www.asnonline.org/education/distancelearning/curricula/geriatrics/Chapter13.pdf. Accessed 14 Apr 2020

  32. 32.

    Yamaguchi T, Omae T, Katsuki S (1969) Quantitative determination of renal vascular changes related to age and hypertension. Jpn Heart J 10(3):248–258

    Article  Google Scholar 

  33. 33.

    Darmady EM, Offer J, Woodhouse MA (1973) The parameters of the aging kidney. J Pathol 109:195–207

    Article  Google Scholar 

  34. 34.

    Hughson MD, Puelles VG, Hoy WE, Douglas-Denton RN, Mott SA, Bertram JF (2014) Hypertension, glomerular hypertrophy and nephrosclerosis: the effect of race. Nephrol Dial Transplant 29(7):1399–1409

    Article  Google Scholar 

Download references

Acknowledgements

We wish to thank Medical English Service (https://www.med-english.com/) for English proofreading of this manuscript.

Funding

This study was funded by the 8020 health promotion.

Author information

Affiliations

  1. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan

    Makiko Kawamoto, Shin-ichi Yamada, Takahiko Gibo, Ryo Kajihara, Sachiho Nagashio, Hirokazu Tanaka, Junichi Yajima, Atsushi Takizawa, Eiji Kondo, Hironori Sakai & Hiroshi Kurita

  2. Department of Dentistry and Oral Surgery, JA Nagano Koseiren Kakeyu-Misayama Rehabilitation Center Kakeyu Hospital, Ueda, Japan

    Sachiho Nagashio

  3. Department of Dentistry and Oral Surgery, North Alps Medical Center Azumi Hospital, Ikeda, Japan

    Junichi Yajima

  4. Department of Dentistry and Oral Surgery, Shinshu Ueda Medical Center, Ueda, Japan

    Atsushi Takizawa

  5. Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan

    Tomoki Kaneko

  6. Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan

    Takeshi Uehara

Authors
  1. Makiko Kawamoto
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  2. Shin-ichi Yamada
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  3. Takahiko Gibo
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  6. Hirokazu Tanaka
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  8. Atsushi Takizawa
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  9. Eiji Kondo
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  11. Tomoki Kaneko
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  12. Takeshi Uehara
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  13. Hiroshi Kurita
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Contributions

Conception and design of the study: Kurita H

Analysis and interpretation of data: Kawamoto M, Yamada S, and Kurita H

Collection and assembly of data: Sakurai A, Gibo T, Kajihara R, Hakoyama Y, Otagiri H, Hashidume M, Kubo K, Aizawa H, Tanaka H, Kondo E, Sakai H, Kaneko T, and Uehara T

Drafting of the article: Kawamoto M and Yamada S

Critical revision of the article for important intellectual content: Yamada S

Final approval of the article: Kurita H

Corresponding author

Correspondence to Shin-ichi Yamada.

Ethics declarations

Ethical approval

The study protocol was approved by the Ethics Committee of the Shinshu University School of Medicine. (No. #4003 and #4264).

Informed consent

Formal consent was not required for this type of study.

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The authors declare no competing interests.

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Cite this article

Kawamoto, M., Yamada, Si., Gibo, T. et al. Relationship between dry mouth and hypertension. Clin Oral Invest (2021). https://doi.org/10.1007/s00784-021-03829-4

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Keywords

  • Dry mouth
  • Submandibular glands
  • Hypertension
  • Arteriosclerosis
  • Xerostomia
  • Intima