Relationship between periodontitis and risk of cardiovascular disease: Insights from the Tromsø Study

Natalia Petrenya; Laila Arnesdatter Hopstock; Gro Eirin Holde; Nils Oscarson; Birgitta Jönsson

doi:10.1002/JPER.22-0004

Relationship between periodontitis and risk of cardiovascular disease: Insights from the Tromsø Study

J Periodontol. 2022 Sep;93(9):1353-1365. doi: 10.1002/JPER.22-0004. Epub 2022 Jun 23.

Authors

Natalia Petrenya¹, Laila Arnesdatter Hopstock², Gro Eirin Holde^{1

3}, Nils Oscarson⁴, Birgitta Jönsson^{1

5}

Affiliations

¹ The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.
² Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
³ Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁴ Clinic of Periodontology, The Public Dental Service, Region Västra Götaland, Skövde, Sweden.
⁵ Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

PMID: 35621303
DOI: 10.1002/JPER.22-0004

Abstract

Background: Few large-scale studies have investigated the association between periodontitis and cardiovascular risk estimated by risk assessment models; moreover, this association remains unexplored in never-smokers. We aimed to examine the relationship between periodontitis and cardiovascular risk in a Norwegian general population, with a focus on never-smokers and the impact of sex and age.

Methods: The present study included 2623 participants from the seventh survey of the Tromsø Study (Tromsø7, 2015-2016), aged 45-74 years, and without previous myocardial infarction or stroke. Periodontitis was defined according to the 2017 American Academy of Periodontology and the European Federation of Periodontology classification system. Participants were categorized by grade based on percentage bone loss/age as no periodontitis/Grade A (low progression rate) and Grade B/C (moderate-rapid progression rate). Low, medium, and high cardiovascular risk was defined based on the Norwegian risk model NORRISK 2. We used ordered logistic regression analysis to examine the association between periodontitis and cardiovascular risk, adjusting for education, toothbrushing frequency, body mass index, and diabetes. Subanalyses included stratification by sex and age (45-54, 55-64, 65-74 years) and a separate analysis of never-smokers.

Results: Periodontitis Grade B/C was associated with higher cardiovascular risk than no periodontitis/Grade A (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.75-2.61). This association was significant in both men and women, all age groups, and never-smokers. However, when never-smokers were stratified by age, the association remained significant only in those aged 65-74 years (OR, 3.00; 95% CI, 1.50-5.99).

Conclusion: Periodontitis Grade B/C was associated with higher cardiovascular risk overall, and in never-smokers aged 65-74 years.

Keywords: alveolar bone loss; cardiovascular disease(s); epidemiology; inflammation; periodontitis; risk factor(s).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiovascular Diseases* / complications
Cardiovascular Diseases* / epidemiology
Female
Humans
Male
Odds Ratio
Periodontitis* / complications
Periodontitis* / epidemiology
Risk Factors
Smoking / epidemiology