How to Help Your Heart

Los Angeles, Calif.: Is gum disease linked to heart disease? If so, isn't there something more proactive about getting the infection under control that I could do?

People with gum problems like gingivitis and periodontitis have higher rates of heart disease, but they also have higher rates of cigarette smoking. Some researchers have speculated that periodontal disease might cause atherosclerosis if inflammation in the gums caused chemicals that injured blood vessels to circulate in the blood stream. However, epidemiological studies have found no relationship between gum problems and heart disease after statistical adjustment for smoking and other risk factors for atherosclerosis.

If you have gum disease, you should brush, floss and do all you can to control it simply to preserve your teeth. And you should do all you can to control your risk factors for heart disease whether or not you have gum problems. But there is no evidence that improving your oral health directly leads to any benefit for your heart.

Albuquerque, N.M.: My 18-year-old son's blood pressure has been running 140/90. He is thin, walks a lot and doesn't smoke. Since childhood he has taken daily decongestants (Rynatan or Sudafed) for allergies. Could that be the cause? If he stops the Sudafed, how long will it take for his blood pressure to come down?

That is a high blood pressure for a teenager, and the decongestants you describe could indeed by the problem. They include a medication called pseudophedrine, which helps runny noses by causing blood vessels to clamp down and allow less fluid to leak into the lining of nose, throat and sinuses. The problem with pseudophedrine is that this constricting of blood vessels can also cause blood pressure to rise.

He should stop those medications, and use just antihistamines (like over the counter loratadine) to control his allergy symptoms. If his blood pressure is still high after a few days, then his doctor should examine him to look for other causes of high blood pressure, such as kidney disease, narrowings of the aorta or arteries supplying the kidneys, or hyperthyroidism.