Cardiovascular risks associated with incident and prevalent periodontal disease.
OBJECTIVE
While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischaemic stroke and total CVD.


METHODS
In a prospective cohort of 39,863 predominantly white women, age ≥45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status [prevalent (18%), incident (7.3%) versus never (74.7%)] were used to assess future cardiovascular risks.


RESULTS
Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14-1.77) for major CVD, 1.72 (1.25-2.38) for MI, 1.41 (1.02-1.95) for ischaemic stroke and 1.27 (1.06-1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00-1.31) for major CVD, 1.27 (1.04-1.56) for MI, 1.12 (0.91-1.37) for ischaemic stroke and 1.15 (1.03-1.28) for total CVD.


CONCLUSIONS
New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events.
Division of Periodontology, Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
Yau-Hua
YH
Yu
Daniel I
DI
Chasman
Julie E
JE
Buring
Lynda
L
Rose
Paul M
PM
Ridker
D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D015994:Incidence; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D010510:Periodontal Diseases / Q000453:epidemiology*; D010512:Periodontal Index; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
C-reactive protein; cardiovascular disease; diabetes; family history of MI; periodontal disease; smoking; survival analysis