Cardiovascular risks associated with incident and prevalent periodontal disease

Abstract

Aim: 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.

Material and 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.

Conclusion: New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events.

Keywords: C-reactive protein; cardiovascular disease; diabetes; family history of MI; periodontal disease; smoking; survival analysis.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Figures

Figures 1

Cumulative incidence rates of major cardiovascular disease (CVD), total CVD, myocardial infarction (MI), and ischemic stroke (iStroke) between women having either prevalent or incident periodontal disease versus never. Hazard ratios and P-values were calculated after accounting for established cardiovascular risk factors, and physical activities (Multivariate model 1 in Supplementary Table 1).