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To the Editor: Dr Grundy¹ discussed evidence that C-reactive protein at baseline is independently associated with an increased risk of hypertension in women. As he indicated, the mechanism remains uncertain. Recent studies^2-3 suggest that women with elevated C-reactive protein levels may be at risk for extensive periodontal disease at baseline and subsequent tooth loss during follow-up. A recent population-based study⁴ found that the intake of some nutrient-rich foods correlated with significantly lower serum levels of beta carotene, folate, and vitamin C in denture-wearers. Antioxidant vitamins are important in the underlying cause of hypertension.⁵ Dietary pattern change during follow-up may be one mechanism that links C-reative protein level with the risk of developing hypertension.

Akira Taguchi, DDS, PhD
akiro@hiroshima-u.ac.jp
Department of Oral and Maxillofacial Radiology
Hiroshima University Hospital
Hiroshima, Japan

1. Grundy SM. Inflammation, hypertension, and the metabolic syndrome. JAMA. 2003;290:3000-3002. FREE FULL TEXT 2. Noack B, Genco RJ, Trevisan M, et al. Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001;72:1221-1227. FULL TEXT | WEB OF SCIENCE | PUBMED 3. Slade GD, Ghezzi EM, Heiss G, et al. Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study. Arch Intern Med. 2003;163:1172-1179. FREE FULL TEXT 4. Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and nutrition in US adults. J Dent Res. 2003;82:123-126. FREE FULL TEXT 5. Chen J, He J, Hamm L, et al. Serum antioxidant vitamins and blood pressure in the United States population. Hypertension. 2002;40:810-816. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:1443-1444.

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