Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-analysis
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Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD).
To aid the United States Preventive Services Task Force (USPSTF) in evaluating whether periodontal disease is an independent novel risk factor for incident CHD.
Studies were identified by searching Medline (1966 through March 2008) and reviewing prior systematic reviews, reference lists, and consulting experts. Prospective cohort studies that assessed periodontal disease, Framingham risk factors, and coronary heart disease incidence in the general adult population without known CHD were reviewed and quality rated using criteria developed by the USPSTF. Meta-analysis of good and fair quality studies was conducted to determine summary estimates of the risk of CHD events associated with various categories of periodontal disease.
We identified seven articles of good or fair quality from seven cohorts. Several studies found periodontal disease to be independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis, and bone loss) ranged from 1.24 (95% CI 1.01–1.51) to 1.34 (95% CI 1.10–1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality, and method of periodontal disease assessment.
Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.
KeywordsCoronary Heart Disease Periodontal Disease Tooth Loss Coronary Heart Disease Event Gingivitis
We thank Miranda Walker, Tanya Weeks and Craig Fleming, MD, for their contributions on this project, and Andrew Hamilton, MLS, MS, for conducting the literature searches.
Conflicts of Interest
- 1.Kochanek KD, Murphy SL, et al. Final Data for 2002. National Statics Reports. Vol 53. Hyattsville, Maryland: National Center for Health Statistics; 2004.Google Scholar
- 2.Mackay J, Mensah GA. The Atlas of Heart Disease and Stroke. Geneva: WHP; 2004.Google Scholar
- 3.Anonymous. Heart Disease and Stroke Statistics. American Heart Association; 2006.Google Scholar
- 26.Mattila KJ, Nieminen M, Valtonen V, et al. Association between dental health and acute myocardial infarction. Br Med J. 1989;298:779–81. In 5/6/05.Google Scholar
- 30.Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499–511, Jan 28.PubMedCrossRefGoogle Scholar
- 31.Deliargyris EN, Marron I, Kadoma W, et al. Periodontal disease and acute myocardial infarction. Circulation. 2000;460(Suppl. II):II–710 (Abstr. 3436), In 5/6/05.Google Scholar
- 46.Genco R, Offenbacher S, Beck J. Periodontal disease and cardiovascular disease: epidemiology and possible mechanisms. J Am Dent Assoc. 2002;133.Google Scholar