Periodontitis related to cardiovascular events and mortality: a long-time longitudinal study

Clin Oral Investig. 2021 Jun;25(6):4085-4095. doi: 10.1007/s00784-020-03739-x. Epub 2021 Jan 28.

Abstract

Objective: The present study assessed if individuals ≥ 60 years of age with periodontitis are more likely to develop stroke or ischemic heart diseases, or at a higher risk of death for 17 years.

Material and methods: At baseline individuals ≥ 60 received a dental examination including a panoramic radiograph. Periodontitis was defined as having ≥ 30% sites with ≥ 5-mm distance from the cementoenamel junction to the marginal bone level. Medical records were annually reviewed from 2001 to 2018. Findings from the medical records identifying an ICD-10 code of stroke and ischemic heart diseases or death were registered.

Results: Associations between periodontitis and incidence of ischemic heart disease were found in this 17-year follow-up study in all individuals 60-93 years (HR: 1.5, CI: 1.1-2.1, p = 0.017), in women (HR: 2.1, CI: 1.3-3.4, p = 0.002), and in individuals 78-96 years (HR: 1.7, CI: 1.0-2.6, p = 0.033). Periodontitis was associated with mortality in all individuals (HR: 1.4, CI: 1.2-1.8, p = 0.002), specifically in men (HR: 1.5, CI: 1.1-1.9, p = 0.006) or in ages 60-72 years (HR: 2.2, CI: 1.5-3.2, p = 0.000). Periodontitis was more prevalent among men (OR: 1.8, CI: 1.3-2.4, p = 0.000).

Conclusions: Individuals with periodontitis have an increased risk for future events of ischemic heart diseases and death.

Clinical relevance: Improving periodontal health in older individuals may reduce overall mortality and ischemic heart diseases. Both dental and medical professionals should be aware of the associations and ultimately cooperate.

Keywords: Epidemiology; Ischemic heart disease; Mortality; Periodontitis.

MeSH terms

  • Adolescent
  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Periodontitis* / complications
  • Periodontitis* / epidemiology
  • Risk Factors
  • Stroke* / epidemiology