Uncontrolled blood pressure among people with diagnosed hypertension screened in dental settings: a systematic review and meta-analysis

Background: Elevated dental office blood pressure (BP) among people with diagnosed hypertension represents a major, reversible gap in care. We estimated the pooled prevalence of dental office BP meeting an uncontrolled threshold among people with diagnosed or treated hypertension and characterized between-study variability.Methods: We searched 10 databases and registers on May 27, 2026. Two reviewers independently screened records, extracted data, and assessed methodological quality using the JBI checklist for prevalence studies. Prevalence was pooled using a random-effects generalized linear mixed model with a logit link.Results: Thirteen studies from 10 countries included 1,083 people with diagnosed or treated hypertension. The pooled prevalence was 53.7% (95% confidence interval, 39.6%–67.3%), with considerable heterogeneity (I2=94%) and a wide 95% prediction interval (13.6%–89.6%). Subgroup estimates were 56.5% for ascertainment by prior diagnosis/history and 48.6% for current antihypertensive treatment (P for difference=0.480); with only 13 studies, this nonsignificant difference does not establish equivalence. Ascertainment basis did not meaningfully explain heterogeneity. Findings were robust to leave-one-out analysis and exclusion of high-risk studies, with no statistical evidence of small-study asymmetry. The overall certainty of evidence was very low.Conclusions: Given the wide variation between settings, the prediction interval is more informative than a single summary figure such as “one in two.” A single elevated dental office BP reading warrants repeat measurement and referral to primary care; it does not confirm uncontrolled hypertension. Dental visits may provide an underused opportunity for BP measurement and referral within the hypertension care cascade.