title: The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease.
abstract: OBJECTIVE
  The objective of this study was to systematically review the epidemiological evidence for an association between periodontitis (PD) and incident atherosclerotic cardiovascular disease (ACVD), including coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease.
  
  
  METHODS
  Systematic review of cohort and case-control studies on the association of clinically or radiographically diagnosed PD and ACVD.
  
  
  RESULTS
  Overall, 12 studies were included in this study (six studies on CHD, three studies on cerebrovascular disease, two studies on both coronary heart and cerebrovascular disease mortality and one study on peripheral arterial disease). All but one study reported positive associations between various periodontal disease measures and the incidence of ACVD, at least in specific subgroups. The association was stronger in younger adults and there was no evidence for an association between PD and incident CHD in subjects older than 65 years. Only one study evaluated the association between PD and secondary cardiovascular events.
  
  
  CONCLUSIONS
  There is evidence for an increased risk of ACVD in patients with PD compared to patients without. However, this may not apply to all groups of the population. There is insufficient evidence for an association between PD and the incidence of secondary cardiovascular events.
authors.affiliation: Department of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Dietrich
authors.forename: Praveen
authors.initials: P
authors.lastname: Sharma
authors.forename: Clemens
authors.initials: C
authors.lastname: Walter
authors.forename: Paul
authors.initials: P
authors.lastname: Weston
authors.forename: James
authors.initials: J
authors.lastname: Beck
mesh_terms: D050197:Atherosclerosis; D003324:Coronary Artery Disease; D003327:Coronary Disease; D006801:Humans; D015994:Incidence; D010518:Periodontitis; D012307:Risk Factors