Non-Cochrane · intervention · PM41801622
Effect of renin-angiotensin-aldosterone system inhibitor and statin medication on periodontal status of patients at risk of cardiovascular disease: a systematic review and meta-analysis.
Khalilurrahman Zahid Affan, Anjani Saskia Kirana, Sulijaya Benso, et al. · The Saudi dental journal · 2026 · PubMed · doi:10.1007/s44445-026-00135-1
Findings
4 findings
| Population | ||||
|---|---|---|---|---|
| Patients with hypercholesterolemia (at risk of cardiovascular disease) | Systemic statin medication | Non-statin groups (diet or normolipidemic controls) | Bleeding on probing index (%) Not specified · Not specified · Overall | MD -13.52 [-23.20, -3.83] GRADE not reported 3 studies · 175 participants |
| Patients with hypercholesterolemia (at risk of cardiovascular disease) | Systemic statin medication | Non-statin groups (diet or normolipidemic controls) | Clinical attachment loss (mm) Not specified · Not specified · Overall | MD -0.16 [-0.40, 0.07] GRADE not reported 4 studies · 232 participants |
| Patients with hypercholesterolemia (at risk of cardiovascular disease) | Systemic statin medication | Non-statin groups (diet or normolipidemic controls) | Probing depth (mm) Not specified · Not specified · Overall | MD -0.38 [-0.53, -0.23] GRADE not reported 4 studies · 232 participants |
| Adults with hypercholesterolemia (at risk of cardiovascular disease) | Systemic statin medication (simvastatin, lovastatin or unspecified statin) | Non-statin comparison (diet-controlled or normolipidemic participants) | Bleeding on probing (BOP) index, % Not specified · Not specified · Estimate as stated in abstract and text (differs slightly from Fig. 3) | MD -13.52 [-23.20, -3.83] GRADE not reported 3 studies · 175 participants |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Ari VC 2016 Statins and IL-1β, IL-10, and MPO Levels in Gingival Crevicular Fluid: Preliminary Results. PMID:27290718 | 2016 | this review only | Bleeding on probing (BOP) index, %; Clinical attachment loss (mm); Probing depth (mm) | not extracted yet |
| Magan-Fernandez A 2014 Association of simvastatin and hyperlipidemia with periodontal status and bone metabolism markers. PMID:24555750 | 2014 | this review only | Clinical attachment loss (mm); Probing depth (mm) | not extracted yet |
| Rad AB 2018 Evaluation of statins (Simvastatin and lovastatin) in reducing periodontal parameters in patients with chronic periodontitis DOI:10.14741/ijmcr/v.6.5.15 | 2018 | this review only | Bleeding on probing (BOP) index, %; Clinical attachment loss (mm); Probing depth (mm) | not extracted yet |
| Rodrigues M 2016 Effect of antihypertensive therapy with angiotensin-converting enzyme inhibitors on chronic periodontitis: a case-control study. PMID:27470973 | 2016 | this review only | not stated | not extracted yet |
| Sayar F 2016 Association of serum lipid indices and statin consumption with periodontal status. PMID:27426870 | 2016 | this review only | Bleeding on probing (BOP) index, %; Clinical attachment loss (mm); Probing depth (mm) | not extracted yet |
| Ustaoglu G 2020 Influence of different anti-hypertensive drugs on gingival overgrowth: A cross-sectional study in a Turkish population. PMID:32991012 | 2021 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with hypertension or hypercholesterolemia (at risk of cardiovascular disease) | Hypercholesterolemia patients on statins (4 studies, n=232 in meta-analysis); hypertensive patients on ACEI/ARB (2 studies) |
| Intervention | ACEI, ARBs or statins (systemic) | Statins (simvastatin, lovastatin, unspecified) (n=4 studies); ACEI and ARB (n=2 studies) |
| Comparison | Another medicated comparison | Diet-controlled or normolipidemic participants; non-ACEI antihypertensives (CCB) |
| Outcomes | Periodontal index (BOP, plaque index, gingival index), clinical attachment loss, probing depth; secondary: diagnosis of periodontal disease | BOP (3 studies), clinical attachment loss (4), probing depth (4); plaque and gingival indices not pooled |
| Study designs | Clinical studies, clinical trials and RCTs published in English in the last 10 years | Cross-sectional (4), non-randomized controlled trial (1), case-control (1) |
| Timing | Not specified | Statin use >3 months; ACEI/ARB >=2 years where stated |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: Yes | NRSI: Yes · RCT: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | NRSI: No · RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | Yes | no |
| 14Heterogeneity explained | Yes | No | no |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |