Oral-Cardiovascular Links Via Blood Biomarkers: An Exposure-Wide Analysis

Cardiovascular diseases remain a global health priority, with oral health linked to cardiovascular risk. However, existing studies have mainly focused on limited periodontal measures and lack analyses of multidimensional oral health.

Using data from 4670 participants in the China Multi-Ethnic Cohort, this cross-sectional study employed an exposure-wide analysis to systematically examine associations between multidimensional oral health indicators and cardiovascular disease-related outcomes, and to exploratorily assess the role of blood and urine-based biomarkers as potential intermediary indicators.

We found that indicators regarding caries, periodontal status, occlusal function, and oral prosthesis were significantly associated with carotid plaque prevalence in total and sex-stratified population. For age-stratified analysis, the associations between oral health indicators and hypertension were predominantly confined to participants aged under 65 years, whereas those with carotid plaque were observed among participants aged 65 years and above. The association with Framingham risk score was observed in both populations.

These findings indicate that multidimensional oral health correlates with cardiovascular outcomes, with obvious sex and age differences, and that blood biomarkers may partially explain these associations. Our findings provide new insights by highlighting the relevance of multidimensional oral health to cardiovascular risk, supporting its consideration in cardiovascular risk assessment.

Multidimensional oral health indicators, including caries, periodontal status, occlusal function, and oral prosthesis are associated with cardiovascular risk, exhibiting sex and age heterogeneity. Blood biomarkers may partially indicate these associations. These findings indicate the potential value of considering oral health in cardiovascular risk assessment.