The Combined Impact of Edentulism and Hypertension on All-Cause Mortality: A 7-Year Prospective Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND AIMS: Edentulism is a recognized risk factor for systemic diseases and mortality. While hypertension is a known contributor to death, especially in older adults, the combined impact of edentulism and hypertension on all-cause mortality remains unclear. This study aimed to assess the independent and combined associations of edentulism and hypertension with all-cause mortality over 7 years in a large Chinese cohort. METHODS: This study utilized data from the China Health and Retirement Longitudinal Study, including 16,479 participants aged ≥45 years followed from 2011 to 2018. Based on baseline dental and hypertension status, participants were categorized into four groups: (1) dentate without hypertension; (2) edentulous without hypertension; (3) dentate with hypertension; (4) edentulous with hypertension. Cox models estimated mortality hazard ratios (HRs), adjusting for age, sex, education, marital status, smoking, activities of daily living impairment, and antihypertensive treatment. RESULTS: Over 7 years, 331 deaths occurred. Compared with dentate participants without hypertension, edentulous individuals without hypertension had a significantly higher mortality risk (adjusted HR: 1.47, 95% confidence interval: 1.06-2.04). This association was pronounced in males (HR: 2.16, 95% confidence interval: 1.40-3.34) but absent in females. Survival curves differed significantly across groups (P < .001). Older age, male sex, lower education, and higher activities of daily living scores were independent mortality predictors. CONCLUSION: Edentulism is an independent risk factor for all-cause mortality, particularly among males without hypertension. Integrating oral health into public health strategies for ageing populations is crucial. CLINICAL RELEVANCE: Oral health status (especially edentulism) should be incorporated into mortality risk assessments for middle-aged and older adults. Healthcare providers must emphasize dental health maintenance in preventive care, with targeted interventions for high-risk subgroups such as edentulous males.
Source: International Dental Journal
Authors: Yan Guo, Mingying Hu, Qian Wang
Institution: Quanzhou Medical College
Language: English
Subfield: Periodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,550
OpenAlex ID: W4416419674