# Effect of renin–angiotensin–aldosterone system inhibitor and statin medication on periodontal status of patients at risk of cardiovascular disease: a systematic review and meta-analysis

## TL;DR

This study examines how medications for heart disease, like RAAS inhibitors and statins, affect gum health in patients at cardiovascular risk.

## Contribution

The study provides a systematic review and meta-analysis on the impact of RAAS inhibitors and statins on periodontal health in cardiovascular disease patients.

## Key findings

- RAAS inhibitors showed inconsistent effects on periodontal status in hypertensive patients.
- Statin use improved bleeding on probing index and probing depth in hypercholesterolemia patients.
- Clinical attachment loss did not significantly differ between statin and other intervention groups.

## Abstract

Among the various risks of cardiovascular disease, hypertension and hypercholesterolemia are the greatest risks. Renin–angiotensin–aldosterone system inhibitor medication, consisting of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, as well as statins, is used to treat hypertension and hypercholesterolemia, respectively. The effect of this medication on inflammatory reactions has been demonstrated by various studies, as well as its effect on periodontal tissue. This study aims to determine the effect of renin–angiotensin–aldosterone system inhibitor medication and statins on the periodontal status of patients at risk of cardiovascular disease.

Search for studies through electronic databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Studies that met the inclusion criteria are included and assessed for risk of bias and then meta-analysed.

Qualitative synthesis showed inconsistent results regarding the effect of RAAS inhibitors on periodontal status. Meta-analysis between the statin group compared with other interventions such as diet found that the mean bleeding on probing index found a statistically significant difference with a mean difference of -13.4% (95% CI:[-23.08;-3.72], p = 0.007), the mean clinical attachment loss did not show any significant difference with a mean difference of -0.16 mm (95% CI: [-0.40;-0.07], p = 0.17), and mean probing depth there was a statistically significant difference between groups with a mean difference of -0.38 mm (95% CI:[-0.53;-0.23], p < 0.00001).

The effect of renin–angiotensin–aldosterone system inhibitor medication in the form of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in hypertensive patients on periodontal status showed inconsistent results and statin medication systemically could improve periodontal status, bleeding on probing index, and probing depth in patients with hypercholesterolemia.

The online version contains supplementary material available at 10.1007/s44445-026-00135-1.

ACEI and ARBs’ effect on periodontal status in hypertensive patients showed inconsistent results.Statin effect on periodontal status in hypercholesterolemia patients showed that it could improve the bleeding on probing index and the probing depth.

ACEI and ARBs’ effect on periodontal status in hypertensive patients showed inconsistent results.

Statin effect on periodontal status in hypercholesterolemia patients showed that it could improve the bleeding on probing index and the probing depth.

The online version contains supplementary material available at 10.1007/s44445-026-00135-1.