Common carotid and brachial artery hemodynamic alterations in periodontal disease

J Clin Periodontol. 2013 May;40(5):431-6. doi: 10.1111/jcpe.12099. Epub 2013 Mar 20.

Abstract

Aim: In patients affected by periodontal disease, hypertension and systemic inflammation might cause an arterial hemodynamic derangement; this, in turn, can act as a mediator of the atherogenic process often seen in these patients. This study aimed at a comprehensive hemodynamic evaluation in periodontal patients.

Methods: Fourty-eight subjects participating to a cardiovascular prevention programme were enrolled. Periodontitis, classical risk factors for atherosclerosis, and shear and tensile forces in both carotid and brachial arteries were evaluated. Calculated periodontal indexes were plaque, gingival and pocket deep (PD) indexes. Simple and multiple regression analyses were performed. Afterwards, 30 of them with normal PD index were compared with 30 carefully - matched patients with periodontitis.

Results: Brachial and carotid parietal tension were significantly associated with periodontal indexes, especially PD-Sum, in both simple (r = 0.42, p < 0.001 for carotid artery and r = 0.36, p < 0.02 for brachial artery) and multiple regression analyses. Shear stress gave similar results. In case-control analysis, shear stress was lower by 15% and 30%, respectively, in carotid and brachial artery in patients with high PD; common carotid parietal tension was higher. Arterial stiffness resulted not associated with periodontitis.

Conclusions: Periodontal disease is associated to a complex atherosclerotic prone hemodynamic derangement, particularly in large elastic arteries.

Publication types

  • Comparative Study

MeSH terms

  • Atherosclerosis / physiopathology
  • Biomechanical Phenomena
  • Blood Flow Velocity / physiology
  • Blood Pressure / physiology
  • Blood Viscosity / physiology
  • Body Mass Index
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiopathology*
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / physiopathology*
  • Case-Control Studies
  • Cohort Studies
  • Dental Plaque Index
  • Diabetes Mellitus / physiopathology
  • Elasticity
  • Female
  • Hemodynamics / physiology*
  • Humans
  • Hyperlipidemias / physiopathology
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Obesity / physiopathology
  • Periodontal Index
  • Periodontal Pocket / classification
  • Periodontitis / physiopathology*
  • Risk Factors
  • Smoking / physiopathology
  • Stress, Mechanical
  • Ultrasonography
  • Vascular Resistance / physiology