Association between Hypertension and Periodontitis: Possible Mechanisms

Figure 1

(1) Inflammatory stimuli induce the expression of cellular adhesion molecules such as vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1) on endothelial cells. (2) Increased VCAM-1 and ICAM-1 expressions recruit more leukocytes to the site of inflammation. (3) Leukocytes infiltration and production of cytokines lead to oxidative stress and inflammation, which result in endothelial dysfunction, affecting the balance of synthesis between vasodilators and vasoconstrictors. The imbalance favours vasoconstriction and adverse vascular remodelling, (4) consequently leading to elevation of blood pressure.