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Oral health care considerations for patients with high blood pressure and/or hypertension

Hypertension control
Oral care consideration
Patients with controlled hypertension. No modifications are necessary.
Asymptomatic patients with BP <149/99 mm Hg and no history of target organ damage. No modifications are necessary.
Asymptomatic patients with BP 150-179/100-109 mm Hg and no history of target organ damage. Assess on an individual basis and with regard to the type and duration of the dental procedure. Be aware of an increased risk for a recurrent ischemic stroke.
Patients with BP >180/110 mm Hg and no target organ damage. Avoid elective dental care. Treat emergencies with analgesics and antibiotics as needed.
Patients with target organ damage, other signs and symptoms of elevated BP, or poorly controlled diabetes mellitus (DM). Emergency care with analgesics and antibiotics as needed when BP is uncontrolled (>140/90 mm Hg or >130/80 mm Hg for patients with DM).
Hypertensive urgency Avoid elective dental care. Treat emergencies with analgesics and antibiotics as needed.
Hypertensive emergency Avoid elective dental care. Treat emergencies with analgesics and antibiotics as needed.

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