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.
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).
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.
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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
High-density lipoprotein cholesterol
Estimated glomerular filtration rate
Magnetic resonance imaging
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
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
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
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
Egan BM, Zhao Y, Axon RN (2010) US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 303(20):2043–2050
Mitchell GF (2014) Arterial stiffness and hypertension. Hypertension 64(1):13–18
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
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
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
Heagerty AM, Heerkens EH, Izzard AS (2010) Small artery structure and function in hypertension. J Cell Mol Med 14(5):1037–1043
Laurent S, Boutouyrie P (2015) The structural factor of hypertension: large and small artery alterations. Circ Res 116(6):1007–1021
Streckfus CF (1995) Salivary function and hypertension: a review of the literature and a case report. J Am Dent Assoc 126(7):1012–1017
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
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)
Dreizen S, Levy BM, Stern MH, Bernick S (1974) Human lingual atherosclerosis. Arch Oral Biol 19(9):813–816
Macleod RI, Soames JV (1988) A morphometric study of age changes in the human lingual artery. Arch Oral Biol 33(6):455–457
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)
Semba I (1989) A histometrical analysis of age changes in the human lingual artery. Arch Oral Biol 34(7):483–489
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
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
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
Scott J (1975) Age, sex and contralateral differences in the volumes of human submandibular salivary glands. Arch Oral Biol 20(12):885–887
Scott J (1977) Quantitative age changes in the histological structure of human submandibular salivary glands. Arch Oral Biol 22(3):221–227
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
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
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)
Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675
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
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
Martinez-Madrigal F, Micheau C (1989) Histology of the major salivary glands. Am J Surg Pathol 13(10):879–899
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
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
Darmady EM, Offer J, Woodhouse MA (1973) The parameters of the aging kidney. J Pathol 109:195–207
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
We wish to thank Medical English Service (https://www.med-english.com/) for English proofreading of this manuscript.
This study was funded by the 8020 health promotion.
The study protocol was approved by the Ethics Committee of the Shinshu University School of Medicine. (No. #4003 and #4264).
Formal consent was not required for this type of study.
Conflict of interest
The authors declare no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
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
- Dry mouth
- Submandibular glands