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Published on: January 21, 2020
Cardiovascular risks associated with incident and prevalent periodontal disease
Yau-Hua Yu1, Daniel I Chasman, Julie E Buring
1Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
Insights
New periodontal disease diagnoses significantly increase women's risk of future cardiovascular events, including heart attack and stroke. This risk applies to both new (incident) and existing (prevalent) cases of gum disease.
Area of Science:
- Cardiovascular Health
- Periodontology
- Epidemiology
Background:
- Prevalent periodontal disease is linked to cardiovascular risk.
- The impact of new-onset periodontal disease on future vascular risk is less understood.
Purpose of the Study:
- To compare the effects of incident versus prevalent periodontal disease on the development of major cardiovascular diseases (CVD), myocardial infarction (MI), and ischaemic stroke.
- To assess future cardiovascular risks associated with different periodontal disease statuses.
Main Methods:
- Prospective cohort study of 39,863 women aged ≥45 years, free of CVD at baseline.
- Follow-up averaged 15.7 years, utilizing Cox proportional hazard models with time-varying periodontal status (prevalent, incident, never).
Main Results:
- Incidence rates for all CVD outcomes were higher in women with prevalent or incident periodontal disease.
- Incident periodontal disease was associated with significantly elevated risks: major CVD (HR 1.42), MI (HR 1.72), ischaemic stroke (HR 1.41), and total CVD (HR 1.27).
- Prevalent periodontal disease also showed increased risks for major CVD (HR 1.14), MI (HR 1.27), and total CVD (HR 1.15).
Conclusions:
- New cases of periodontal disease, in addition to pre-existing conditions, place women at significantly elevated risks for future cardiovascular events.
- This highlights the importance of addressing both new and ongoing periodontal issues for cardiovascular health in women.
Aim:
While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischaemic stroke and total CVD.
Material And Methods:
In a prospective cohort of 39,863 predominantly white women, age ≥45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status [prevalent (18%), incident (7.3%) versus never (74.7%)] were used to assess future cardiovascular risks.
Results:
Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14-1.77) for major CVD, 1.72 (1.25-2.38) for MI, 1.41 (1.02-1.95) for ischaemic stroke and 1.27 (1.06-1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00-1.31) for major CVD, 1.27 (1.04-1.56) for MI, 1.12 (0.91-1.37) for ischaemic stroke and 1.15 (1.03-1.28) for total CVD.
Conclusion:
New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events.
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