Arterial hypertension in dental practice. Dentist's everyday life.

According to the recommendations of the European Society of Cardiology in 2018, hypertension is one of the most common diseases found in cardiology. Its widespread, severe consequences and lifelong treatment require a careful approach from both - cardiologists and doctors of other specialties, in particular dentists. Arterial hypertension occupies one of the leading places in terms of its contribution to mortality from cardiovascular diseases, which prevalence in the world is more than 1.4 billion people and the daily damage counts more than 28,000 lives. Today, during the COVID-19 pandemic, cases of hypertension are steadily increasing, and the number of complications associated with hypertension is also increasing. Often these complications become fatal for the patient, and such a situation requires the doctor to immediately and aggressively correct drug therapy. The pathophysiological prerequisite for the manifestation of hypertension or for exacerbation of existing hypertension is the effect of the virus on the vascular wall and the renin-angiotensin-aldosterone system. The cascade of pathological processes is realized through the main components of this system, which both circulate in the blood plasma and are synthesized directly in organs and tissues. These cytokines determine the damage of target organs, in particular the heart and kidneys, which leads to a heavier course of arterial hypertension and closes the pathological circle. At the present stage, the role of dentists in the prevention and diagnosis of general somatic complications in patients in outpatient clinics is increasing every year. The number of people seeking dental care is continuously increasing, the age composition of patients is changing. Thus, in urban outpatient clinics, the majority of patients in need of dental care are over 65 years old, and the prevalence of arterial hypertension in this age group reaches 50-65%. The dentist is often the first doctor who can suspect hypertension in a patient and refer him to a specialist for consultation. Previously, this was the prerogative of general medical institutions, but now it is actively used in dental clinics in Europe and Asia. Dentists have been involved in the detection of arterial hypertension for more than 30 years. A study conducted among dentists in the United States showed that American doctors very rarely measure blood pressure in their patients. Based on these data, dental clinics were recommended to include blood pressure measurement at the stage of the initial examination of patients. Every dentist should be able to recognize the arterial hypertension and provide first aid, which is of particular importance in the context of a coronavirus pandemic. When the doctor knows what to do in case of an emergency, he can not only help the patient at the moment, but also determine his further prognosis.