Age-dependent associations between chronic periodontitis/edentulism and risk of coronary heart disease.
BACKGROUND
Several epidemiological studies have suggested periodontitis as a risk factor for coronary heart disease (CHD), but results have been inconsistent.


RESULTS
We evaluated the association between clinical and radiographic measures of periodontitis, edentulism, and incident CHD (angina, myocardial infarction, or fatal CHD) among 1203 men in the VA Normative Aging and Dental Longitudinal Studies who were followed up with triennial comprehensive medical and dental examinations up to 35 years (median 24 years). Cox proportional hazards models with time-varying effects of exposure and potential confounders were fit. We found a significant dose-dependent association between periodontitis and CHD incidence among men < 60 years of age (hazard ratio 2.12, 95% confidence interval 1.26 to 3.60 comparing highest versus lowest category of radiographic bone loss, P for trend=0.02), independent of age, body mass index, smoking, alcohol intake, diabetes mellitus, fasting glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, hypertension, systolic and diastolic blood pressure, education, marital status, income, and occupation. No association was found among men > 60 years of age. Similar results were found when the sum of probing pocket depths was used as a measure of periodontitis. Among men > or = 60 years of age, edentulous men tended to have a higher risk of CHD than dentate men in the lowest bone loss (hazard ratio 1.61, 95% confidence interval 0.95 to 2.73) and lowest pocket depth (hazard ratio 1.72, 95% confidence interval 1.03 to 2.85) categories, independent of confounders.


CONCLUSIONS
Chronic periodontitis is associated with incidence of CHD among younger men, independent of established cardiovascular risk factors.
Dietrich
Thomas
T
Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, Mass, USA.
Jimenez
Monik
M
Krall Kaye
Elizabeth A
EA
Vokonas
Pantel S
PS
Garcia
Raul I
RI
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications* / Q000453:epidemiology*; D012307:Risk Factors; D016388:Tooth Loss / Q000150:complications* / Q000453:epidemiology*