Uncontrolled hypertension at the dentist: a case report of integrated healthcare

Hypertension is a risk factor for major cardiovascular events and it is usually detected and managed by general medical practitioners (GPs) in primary care. However, it is estimated that 4.8 million adults are living with untreated high blood pressure (BP) in the UK. Health authorities are encouraging more collaborative work across health professions to find and refer individuals with undiagnosed hypertension. In this case, in 2022, a 65-year-old man with a previous history of hypertension, taking antihypertensive medication, attended a BP clinic at the University of Plymouth, Peninsula Dental School as part of a hypertension case finding pilot. His systolic and diastolic BP were 150 and 85 mmHg, respectively, and as per the trial protocol, a referral letter was sent to his GP for suspected further assessment and investigation. Then, an onward referral was made to secondary care and the participant was subsequently hospitalised for 13 days for treatment of heart failure and suspected acute coronary syndrome. This case report highlights that BP readings taken in a primary care dental setting can be very useful and recommends better integration of dental services into primary care to reduce the risk of major cardiovascular events. Blood pressure readings taken in clinical dental settings may serve as an additional approach for hypertension monitoring (and case finding) in individuals with high cardiovascular risk.Dental primary care settings and dental professionals can provide accurate blood pressure readings and medical histories to make appropriate referrals to GPs regarding their patients' cardiovascular health.Integrated dental-GP care pathways and referral networks could potentially reduce the risk of major cardiovascular events and associated mortality.