COEXISTENCE OF HYPERTENSION AND OTHER VARIABLES IN ORAL AND MAXILLOFACIAL CLINIC

Background: Hypertension is quite important in oral and maxillofacial settings as it may present as an emergency during treatment or may necessitate a modification in the patient's management Objective: To determine the importance of routine blood pressure measurement and determine the relationship of hypertension with specific maxillofacial disease conditions. Subjects and methods: This was a prospective survey of patients who attended oral and maxillofacial clinic in University of Uyo Teaching hospital Uyo. A total of 116 patients who were found to have elevated blood pressure were assessed. An equal number of patients without elevated blood pressure was also assessed for comparison. Results: In those with hypertension, the age ranged between 18 and 77 years with a mean age of 40 ± 11.0 years. Females represented 38.79% (n = 45) and males 61.21% (n = 71) of the total study group. Prehypertension was present in 23.28% (n=27), while Stage 1 hypertension was present in 45.14% (n=57), and Stage 2 in 27.59% (n=32) of the patients. Odontalgia was recorded as the condition with the highest frequency of hypertension with 29.31% (34) closely followed by trigeminal neuralgia with 24.14% (28). Conclusion: The high prevalence of hypertension observed in this study without prior knowledge of the patients is worrisome considering the potential consequence during procedures. Also, some of the disease conditions particularly odontalgia and trigeminal neuralgic pains may have direct association with hypertension, although the one that preceded the other could not be determined from this study.

neck cancers and hypertension is essential and should be considered to be a part of standard care.Unfortunately, this situation is not always the case.Most practitioners do not make a habit of taking blood pressure reading, even though many possess 6 the necessary equipment and expertise.The incidence of hypertension among dental 7 patients has been reported to be as high as 32%.The adult dental health survey in 1998 reported that 59% of the population attend for a regular dental check-8 up and would thus be available for screening.Patients visiting maxillofacial care facilities may present with different comorbidities, which sometimes may be unknown to them or they may be on a complex range of medications for their medical conditions.The goal of treatment is to deliver safe and effective treatment without causing any medical emergency.There seem to be paucity of documented information on the prevalence of undiagnosed hypertension in relation to specific oral and maxillofacial conditions.The objective of this study therefore was to determine the relevance of routine BP measurement and determine the correlation of hypertension with specific maxillofacial disease conditions as possible risk factors in adult patients attending oral and maxillofacial clinic.

SUBJECTS AND METHODS
This was a prospective study conducted in patients who visited oral and maxillofacial clinic of university of Uyo teaching hospital from August 2015-August July 2017.Inclusion criteria were all consecutive patients who did not have previous knowledge of their hypertensive status.Patients already on hypertensive management or already diagnosed were excluded.The variables collected were age, gender, systolic and diastolic blood pressure which were recorded during two visits and the average value taken.The blood pressure (BP) was measured using a digital sphygmomanometer.Detail histories of the patients were documented.Different oral and maxillofacial related problems revealed in the history were broadly categorised and documented under odontogenic tumors, cysts, facial space infections, odontalgia, trigeminal neuralgic pains and trauma.medication and disease status.Hence, this will then help to decrease the number of incidents of serious life-threatening diseases and complications such cardiovascular diseases and strokes during or after treatment.The percentage of those who wrongly presumed that their blood pressure was normal in this study was 50% of the study population.This discrepancy in patients' opinion of their blood pressure and objective finding is of important clinical significance.It is necessary that patients should have their blood pressures checked at initial registration, before and after a major procedure is carried out.

CONCLUSION
The high prevalence of hypertension observed in this study without prior knowledge of the patients is worrisome considering the potential consequence during procedures.Also, some of the disease conditions particularly odontalgia and trigeminal neuralgic pains may have direct association with hypertension, although the one that preceded the other could not be determined from this study.
SPSS Inc, Chicago, IL) statistical software package.Paired-sample t test was used to analyse the variation in parameters within the groups while independent-sample t test was used to compare the means of the two groups.To compare the frequency between the groups, a chi-square test was used.The critical level of significance was set at p < 0.05.).
RESULTSThe total number of patients with hypertension assessed in this study was 116.Their age ranged between 18 and 77 years with a mean age of 40 ± 11.0 years.Females represented 38.79% (n = 45) and males 61.21% (n = 71) of the total study group.Prehypertension was present in 23.28% (n=27) of the patients (Table4) while Stage 1 hypertension was present in 45.14% (n=57), and Stage 2 in 27.59% (n=32) of the patients.Mean systolic BP in the study population was 145.5 ± 10.3 mm Hg, while the mean diastolic BP was 100 ± 10.5 mm Hg.The prevalence of hypertension among the patients by age shows the highest frequency to be 42 (36.20%) in the age range 48-57 years with the least recorded to be age range 18-27 years as shown in table3.