Periodontal disease in patients with chronic coronary heart disease: Prevalence and association with cardiovascular risk factors.
OBJECTIVE
There are reported links between periodontal disease (PD) and cardiovascular (CV) risk but data are lacking, especially from populations with established coronary heart disease (CHD). This study describes self-reported indicators of PD and associations with CV risk factors in a global stable CHD population.


RESULTS
A total of 15,828 participants in the global STABILITY trial underwent a physical examination, blood sampling, and completed a lifestyle questionnaire. They reported remaining number of teeth (none, 1-14, 15-20, 21-25 or 26-32 (all)) and frequency of gum bleeding (never/rarely, sometimes, often or always). Adjusted linear and logistic regression models assessed associations between tooth loss, gum bleeding, and socioeconomic and CV risk factors. A total of 40.9% of participants had <15 remaining teeth; 16.4% had no teeth; and 25.6% reported gum bleeding with large differences in prevalence among countries, regions and ethnic groups. Less tooth loss was associated with lower levels of glucose, low-density lipoprotein (LDL) cholesterol, systolic blood pressure, waist circumference and hs-CRP; higher estimated glomerular filtration rate; decreased odds for diabetes and smoking, and increased odds for higher education, alcohol consumption and work stress. Gum bleeding was associated with higher LDL cholesterol and systolic blood pressure; decreased odds for smoking, but increased odds for higher education, alcohol consumption and stress.


CONCLUSIONS
Self-reported indicators of PD were common in this chronic CHD population and were associated with an increasing socioeconomic and CV risk factor burden. However, causality between self-reported PD and CV risk and outcome needs further investigation.
Department of Medical Sciences, Uppsala University, Sweden ola.vedin@ucr.uu.se.
Ola
O
Vedin
Department of Medical Sciences, Uppsala University, Sweden.
Emil
E
Hagström
Duke Clinical Research Institute, USA.
Dianne
D
Gallup
Duke Clinical Research Institute, USA.
Megan L
ML
Neely
Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand.
Ralph
R
Stewart
University of Ulm Medical Centre, Germany.
Wolfgang
W
Koenig
Postgraduate Medical School, Grochowski Hospital, Poland.
Andrzej
A
Budaj
Ramathibodi Hospital, Mahidol University, Thailand.
Piyamitr
P
Sritara
Department of Medical Sciences, Uppsala University, Sweden.
Lars
L
Wallentin
Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand.
Harvey D
HD
White
Department of Medical Sciences, Uppsala University, Sweden.
Claes
C
Held
D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005884:Gingival Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010510:Periodontal Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000175:diagnosis / Q000453:epidemiology
Tooth loss; coronary heart disease; gum bleeding; periodontal disease; risk factors