Angiographically confirmed coronary heart disease and periodontal disease in middle-aged males.
BACKGROUND
The aim of this study was to investigate whether an association could be demonstrated between coronary heart disease (CHD) and chronic periodontitis in a population of middle-aged males in Northern Ireland.


METHODS
A case-control design was used. Cases were men aged over 40 years with angiographically proven CHD. Controls were age-matched males, with no evidence of CHD, randomly drawn from the same locality as the cases. Each subject had a clinical periodontal examination and completed a detailed sociodemographic questionnaire. High sensitivity C-reactive protein (CRP) was measured in serum by immunoturbidimetry.


RESULTS
There were 92 cases (mean age 56.7 years; SD = 6.3) and 79 controls (mean age 58.2 years; SD = 6.7). The CHD cases had an average of three teeth less than the controls (P <0.0001). A higher proportion of sites examined in cases than controls had plaque (P = 0.004), bleeding on probing (P = 0.013), and probing depths of > or = 4 mm (P = 0.006) or > or = 6 mm (P = 0.03). Subjects with > or = 4 mm pocketing in more than 20% of their interproximal sites and those with deep pocketing (> or = 6 mm) were classified as having poor periodontal status. A total of 35 cases (38%), compared to only 13 controls (16%), had a poor periodontal status (P = 0.0017). Men with a poor periodontal condition had higher levels of CRP (median 2.19 mg/l) than those with good periodontal health (median 1.42 mg/l), P = 0.007. After adjusting for smoking, academic achievement, alcohol consumption, unemployment, ability to maintain body weight, regular exercise, ability to relax daily, having a hobby or pastime, plaque, and CRP, logistic regression analysis showed that poor periodontal status was significantly associated with CHD, with an adjusted odds ratio of 3.06 and 95% confidence intervals of 1.02 to 9.17, P = 0.046.


CONCLUSIONS
There was an association between coronary heart disease and poor periodontal status in the middle-aged males investigated. This association was independent of diabetes and all other cardiovascular risk factors investigated.
Briggs
James E
JE
Oral Science Research Centre, School of Dentistry, Queen's University, Belfast, Northern Ireland, UK.
McKeown
Pascal P
PP
Crawford
Vivienne L S
VL
Woodside
Jayne V
JV
Stout
Robert W
RW
Evans
Alun
A
Linden
Gerard J
GJ
D000328:Adult; D000428:Alcohol Drinking; D001835:Body Weight; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002908:Chronic Disease; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D003773:Dental Plaque / Q000145:classification; D004522:Educational Status; D015444:Exercise; D005884:Gingival Hemorrhage / Q000145:classification; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland; D010514:Periodontal Pocket / Q000145:classification; D010518:Periodontitis / Q000097:blood / Q000150:complications*; D012063:Relaxation; D012907:Smoking; D016388:Tooth Loss / Q000145:classification; D014478:Unemployment
D002097:C-Reactive Protein