{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:40:22Z","timestamp":1774615222889,"version":"3.50.1"},"reference-count":68,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>We aimed to investigate the association between blood pressure (BP) and tooth loss and the mediation effect of age. A cross-sectional study from a reference dental hospital was conducted from September 2017 to July 2020. Single measures of BP were taken via an automated sphygmomanometer device. Tooth loss was assessed through oral examination and confirmed radiographically. Severe tooth loss was defined as 10 or more teeth lost. Additional study covariates were collected via sociodemographic and medical questionnaires. A total of 10,576 patients were included. Hypertension was more prevalent in severe tooth loss patients than nonsevere tooth lost (56.1% vs. 39.3%, p &lt; 0.001). The frequency of likely undiagnosed hypertension was 43.4%. The adjusted logistic model for sex, smoking habits and body mass index confirmed the association between continuous measures of high BP and continuous measures of tooth loss (odds ratio (OR) = 1.05, 95% CI: 1.03\u20131.06, p &lt; 0.001). Age mediated 80.0% and 87.5% of the association between periodontitis with both systolic BP (p &lt; 0.001) and diastolic BP (p &lt; 0.001), respectively. Therefore, hypertension and tooth loss are associated, with a consistent mediation effect of age. Frequency of undiagnosed hypertension was elevated. Age, gender, active smoking, and BMI were independently associated with raised BP.<\/jats:p>","DOI":"10.3390\/ijerph18010285","type":"journal-article","created":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T19:54:46Z","timestamp":1609703686000},"page":"285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Blood Pressure and Tooth Loss: A Large Cross-Sectional Study with Age Mediation Analysis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-4077","authenticated-orcid":false,"given":"Jos\u00e9 Jo\u00e3o","family":"Mendes","sequence":"first","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"},{"name":"Evidenced-Based Hub, CiiEM, Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"given":"Jo\u00e3o","family":"Viana","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-9458","authenticated-orcid":false,"given":"Filipe","family":"Cruz","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7529-9025","authenticated-orcid":false,"given":"Dinis","family":"Pereira","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"given":"S\u00edlvia","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Patologia Cl\u00ednica, Centro Hospitalar Lisboa Ocidental, 1449-005 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6115-1986","authenticated-orcid":false,"given":"Paula","family":"Pereira","sequence":"additional","affiliation":[{"name":"Grupo de Estudos em Nutri\u00e7\u00e3o Aplicada (GENA), CiiEM, Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-5936","authenticated-orcid":false,"given":"Lu\u00eds","family":"Proen\u00e7a","sequence":"additional","affiliation":[{"name":"Evidenced-Based Hub, CiiEM, Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"},{"name":"Quantitative Methods for Health Research (MQIS), CiiEM, Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-260X","authenticated-orcid":false,"given":"Vanessa","family":"Machado","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"},{"name":"Evidenced-Based Hub, CiiEM, Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-8263","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Botelho","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"},{"name":"Evidenced-Based Hub, CiiEM, Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7659-4392","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Rua","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]},{"given":"Ana Sintra","family":"Delgado","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), Egas Moniz\u2014Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0140-6736(05)17741-1","article-title":"Global burden of hypertension: Analysis of worldwide data","volume":"365","author":"Kearney","year":"2005","journal-title":"Lancet"},{"key":"ref_2","unstructured":"(2020, August 17). WHO Hypertension. Available online: https:\/\/www.who.int\/health-topics\/hypertension\/#tab=tab_1."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/0002-8703(87)90588-6","article-title":"Hypertension and other risk factors in coronary heart disease","volume":"114","author":"Kannel","year":"1987","journal-title":"Am. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/j.1600-051X.2012.01916.x","article-title":"Tooth loss is associated with increased blood pressure in adults\u2014A multidisciplinary population-based study","volume":"39","author":"Peres","year":"2012","journal-title":"J. Clin. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1097\/00004872-199816080-00004","article-title":"Long-term cost and life-expectancy consequences of hypertension","volume":"16","author":"Kiiskinen","year":"1998","journal-title":"J. Hypertens."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/HJH.0000000000001186","article-title":"Factors and consequences of hypertension","volume":"35","author":"Zanchetti","year":"2017","journal-title":"J. Hypertens."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1093\/cvr\/cvz201","article-title":"Periodontitis is associated with hypertension: A systematic review and meta-analysis","volume":"116","author":"Suvan","year":"2020","journal-title":"Cardiovasc. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Machado, V., Aguilera, E.M., Botelho, J., Hussain, S.B., Leira, Y., Proen\u00e7a, L., D\u2019Aiuto, F., and Mendes, J.J. (2020). Association between Periodontitis and High Blood Pressure: Results from the Study of Periodontal Health in Almada-Seixal (SoPHiAS). J. Clin. Med., 9.","DOI":"10.3390\/jcm9051585"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12903-019-0966-3","article-title":"Association between tooth loss and hypertension among older Chinese adults: A community-based study","volume":"19","author":"Da","year":"2019","journal-title":"BMC Oral Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.atherosclerosis.2008.07.017","article-title":"Tooth loss, hypertension and risk for stroke in a Korean population","volume":"203","author":"Choe","year":"2009","journal-title":"Atherosclerosis"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.ijcard.2014.07.083","article-title":"Edentulism associates with poor cardiovascular health. Results from the Atahualpa Project","volume":"176","author":"Mera","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_12","first-page":"2150132720928670","article-title":"Association Between Pulsatile Components of Blood Pressure and Severe Tooth Loss in Rural Ecuador: The Three Villages Study","volume":"11","author":"Mera","year":"2020","journal-title":"J. Prim. Care Community Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1177\/0022034517693566","article-title":"Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990\u20132015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors","volume":"96","author":"Kassebaum","year":"2017","journal-title":"J. Dent. Res."},{"key":"ref_14","unstructured":"World Health Organization (2020, December 10). Oral Health. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/oral-health."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"616","DOI":"10.12968\/denu.2009.36.10.616","article-title":"Consequences of tooth loss: 1. The patient perspective--aesthetic and functional implications","volume":"36","author":"Craddock","year":"2009","journal-title":"Dent. Update"},{"key":"ref_16","first-page":"98","article-title":"The effect of the loss of teeth on diet and nutrition","volume":"34","author":"Chauncey","year":"1984","journal-title":"Int. Dent. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1136\/bmj.1.4750.145-a","article-title":"The Nutritional Revolution","volume":"1","author":"McCance","year":"1952","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1007\/s11136-017-1587-4","article-title":"Tooth loss and general quality of life in dentate adults from Southern Brazil","volume":"26","author":"Haag","year":"2017","journal-title":"Qual. Life Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1093\/ajh\/hpv025","article-title":"Oral health and blood pressure: The IPC cohort","volume":"28","author":"Darnaud","year":"2015","journal-title":"Am. J. Hypertens."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e4710","DOI":"10.7717\/peerj.4710","article-title":"IL-6 and TNF-\u03b1 salivary levels according to the periodontal status in Portuguese pregnant women","volume":"6","author":"Machado","year":"2018","journal-title":"PeerJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"211","DOI":"10.14310\/horm.2002.1582","article-title":"Pregnancy-Induced hypertension","volume":"10","author":"Kintiraki","year":"2015","journal-title":"Hormones"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1038\/s41440-018-0161-y","article-title":"Determinants of pulse pressure amplification in hypertensive and diabetic patients","volume":"42","author":"Yannoutsos","year":"2019","journal-title":"Hypertens. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"E35","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of Blood Pressure in Humans: A Scientific Statement from the American Heart Association","volume":"73","author":"Muntner","year":"2019","journal-title":"Hypertension"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1097\/HJH.0b013e3281fc975a","article-title":"2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)","volume":"25","author":"Mancia","year":"2007","journal-title":"J. Hypertens."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1093\/eurheartj\/eht151","article-title":"2013 ESH\/ESC guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)","volume":"34","author":"Mancia","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/1747493016676621","article-title":"Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project)","volume":"12","author":"Mera","year":"2017","journal-title":"Int. J. Stroke"},{"key":"ref_29","unstructured":"World Health Organization (2020, December 10). Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus. Available online: https:\/\/www.who.int\/diabetes\/publications\/report-hba1c_2011.pdf?ua=1."},{"key":"ref_30","first-page":"364","article-title":"Relationship between elevated automatic blood pressure readings and manual blood pressure readings in adult patients with normal and high body mass index","volume":"119","author":"Hussain","year":"2019","journal-title":"J. Am. Osteopath. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1017\/thg.2014.83","article-title":"Multivariate modeling of body mass index, pulse pressure, systolic and diastolic blood pressure in Chinese twins","volume":"18","author":"Wu","year":"2015","journal-title":"Twin Res. Hum. Genet."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/10641963.2017.1281940","article-title":"A comparative research on obesity hypertension by the comparisons and associations between waist circumference, body mass index with systolic and diastolic blood pressure, and the clinical laboratory data between four special Chinese adult groups","volume":"40","author":"Wu","year":"2018","journal-title":"Clin. Exp. Hypertens."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2478\/10004-1254-63-2012-2164","article-title":"Ageing, arterial blood pressure, body mass index, and diet","volume":"63","year":"2012","journal-title":"Arh. Hig. Rada Toksikol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1111\/jcpe.12685","article-title":"Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: Consensus report of group 2 of the joint EFP\/ORCA workshop on the boundaries between caries and periodontal diseases","volume":"44","author":"Chapple","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1038\/nrmicro2337","article-title":"Periodontitis: A polymicrobial disruption of host homeostasis","volume":"8","author":"Darveau","year":"2010","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1096\/fj.201500088R","article-title":"Role of chemokine RANTES in the regulation of perivascular inflammation, T-cell accumulation, and vascular dysfunction in hypertension","volume":"30","author":"Mikolajczyk","year":"2016","journal-title":"FASEB J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1111\/bph.14536","article-title":"Th1-type immune responses to Porphyromonas gingivalis antigens exacerbate angiotensin II-dependent hypertension and vascular dysfunction","volume":"176","author":"Nosalski","year":"2019","journal-title":"Br. J. Pharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Dar-Odeh, N., Borzangy, S., Babkair, H., Farghal, L., Shahin, G., Fadhlalmawla, S., Alhazmi, W., Taher, S., and Abu-Hammad, O. (2019). Association of dental caries, retained roots, and missing teeth with physical status, diabetes mellitus and hypertension in women of the reproductive age. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16142565"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1016\/j.jdent.2014.08.012","article-title":"Tooth loss and its association with dietary intake and diet quality in American adults","volume":"42","author":"Zhu","year":"2014","journal-title":"J. Dent."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1016\/S0140-6736(14)60685-1","article-title":"Blood pressure and incidence of twelve cardiovascular diseases: Lifetime risks, healthy life-years lost, and age-specific associations in 1\u00b725 million people","volume":"383","author":"Rapsomaniki","year":"2014","journal-title":"Lancet"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1177\/0022034517709737","article-title":"Oral Conditions and Health-Related Quality of Life: A Systematic Review","volume":"96","author":"Haag","year":"2017","journal-title":"J. Dent. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-015-2528-1","article-title":"Association of physical activity with blood pressure and blood glucose among Malaysian adults: A population-based study Chronic Disease epidemiology","volume":"15","author":"Teh","year":"2015","journal-title":"BMC Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00394-016-1257-2","article-title":"Sugars, obesity, and cardiovascular disease: Results from recent randomized control trials","volume":"55","author":"Rippe","year":"2016","journal-title":"Eur. J. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Hoare, E., Varsamis, P., Owen, N., Dunstan, D.W., Jennings, G.L., and Kingwell, B.A. (2017). Sugar-and intense-sweetened drinks in Australia: A systematic review on cardiometabolic risk. Nutrients, 9.","DOI":"10.3390\/nu9101075"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Mansoori, S., Kushner, N., Suminski, R.R., Farquhar, W.B., and Chai, S.C. (2019). Added sugar intake is associated with blood pressure in older females. Nutrients, 11.","DOI":"10.3390\/nu11092060"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/S0140-6736(12)60987-8","article-title":"Diabetes and hypertension: The bad companions","volume":"380","author":"Ferrannini","year":"2012","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.2174\/138161210792062920","article-title":"Cigarette Smoking and Hypertension","volume":"16","author":"Virdis","year":"2010","journal-title":"Curr. Pharm. Des."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/sj.ebd.6401182","article-title":"Impact of smoking on tooth loss in adults","volume":"17","author":"Carson","year":"2016","journal-title":"Evid. Based. Dent."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00125-011-2342-y","article-title":"Periodontitis and diabetes: A two-way relationship Matrix metalloproteinase NHANES National Health and Nutrition Examination Survey","volume":"55","author":"Preshaw","year":"2012","journal-title":"Diabetologia"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jama.2013.184182","article-title":"Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries","volume":"310","author":"Chow","year":"2013","journal-title":"JAMA\u2014J. Am. Med. Assoc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1093\/fampra\/cmy075","article-title":"Health-related determinants of undiagnosed arterial hypertension: A population-based study","volume":"36","author":"Chau","year":"2018","journal-title":"Fam. Pract."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1161\/HYPERTENSIONAHA.117.09188","article-title":"Prevalence, Treatment, and Control Rates of Conventional and Ambulatory Hypertension Across 10 Populations in 3 Continents","volume":"70","author":"Melgarejo","year":"2017","journal-title":"Hypertension"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1097\/HJH.0000000000002350","article-title":"Income-based inequalities in hypertension and in undiagnosed hypertension: Analysis of Health Survey for England data","volume":"38","author":"Scholes","year":"2020","journal-title":"J. Hypertens."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"E67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart Disease and Stroke Statistics\u20142018 Update: A Report from the American Heart Association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1001\/jama.2014.15388","article-title":"Patients with undiagnosed hypertension hiding in plain sight","volume":"312","author":"Wall","year":"2014","journal-title":"JAMA\u2014J. Am. Med. Assoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1161\/HYPERTENSIONAHA.114.04394","article-title":"Burden of undiagnosed hypertension in sub-saharan africa: A systematic review and meta-analysis","volume":"65","author":"Ataklte","year":"2015","journal-title":"Hypertension"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/jch.13798","article-title":"Asian management of hypertension: Current status, home blood pressure, and specific concerns in India","volume":"22","author":"Sogunuru","year":"2020","journal-title":"J. Clin. Hypertens."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/S0140-6736(18)31887-7","article-title":"Prevalence and control of hypertension","volume":"392","author":"Bovet","year":"2018","journal-title":"Lancet"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.1016\/S0140-6736(16)31134-5","article-title":"A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: The Lancet Commission on hypertension","volume":"388","author":"Olsen","year":"2016","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.repc.2018.10.012","article-title":"Sociodemographic disparities in hypertension prevalence: Results from the first Portuguese National Health Examination Survey","volume":"38","author":"Rodrigues","year":"2019","journal-title":"Rev. Port. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1875-595X.2002.tb00595.x","article-title":"Periodontal Screening and Recording (PSR) Index: Precursors, utility and limitations in a clinical setting","volume":"52","author":"Landry","year":"2002","journal-title":"Int. Dent. J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e5258","DOI":"10.7717\/peerj.5258","article-title":"Prevalence and extent of chronic periodontitis and its risk factors in a Portuguese subpopulation: A retrospective cross-sectional study and analysis of Clinical Attachment Loss","volume":"6","author":"Machado","year":"2018","journal-title":"PeerJ"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-019-52116-6","article-title":"Study of Periodontal Health in Almada-Seixal (SoPHiAS): A cross-sectional study in the Lisbon Metropolitan Area","volume":"9","author":"Botelho","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Botelho, J., Machado, V., Proen\u00e7a, L., Oliveira, M.J., Cavacas, M.A., Amaro, L., \u00c1guas, A., and Mendes, J.J. (2020). Perceived xerostomia, stress and periodontal status impact on elderly oral health-related quality of life: Findings from a cross-sectional survey. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01183-7"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12903-020-01219-y","article-title":"Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: A structural equation modelling analysis","volume":"20","author":"Machado","year":"2020","journal-title":"BMC Oral Health"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1111\/jcpe.13186","article-title":"Psychometric properties of the Brief Illness Perception Questionnaire (Brief-IPQ) in periodontal diseases","volume":"46","author":"Machado","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Machado, V., Botelho, J., Proen\u00e7a, L., and Mendes, J.J. (2020). Self-reported illness perception and oral health related quality of life predict adherence to initial periodontal treatment. J. Clin. Periodontol., in press.","DOI":"10.1111\/jcpe.13337"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1080\/00016357.2018.1564839","article-title":"Oral hygiene habits in Portugal: Results from the first Health Examination Survey (INSEF 2015)","volume":"77","author":"Santos","year":"2019","journal-title":"Acta Odontol. Scand."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/1\/285\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:06:18Z","timestamp":1760159178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/1\/285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,2]]},"references-count":68,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1]]}},"alternative-id":["ijerph18010285"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18010285","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,2]]}}}