The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: A meta-analysis
Section snippets
Literature search and study selection
Literature searches were done by investigators (A. B. and R. A.) using the PubMed computerized database (1966-2006), Cochrane Controlled Trials Register (1970-2006), EMBASE (1980-2006), and CINAHL (1982-2006). The search was restricted to the articles including human subjects. In addition, manual searches were performed through the reference lists of published articles and review papers. Any unpublished studies were excluded.
For oral pathology, the following terms were used: periodontal disease
Results
As shown in Figure 1, meta-analysis of the 5 prospective cohort studies (86 092 patients) indicated that individuals with PD had a 1.14 times higher risk of developing CHD than the controls (95% CI 1.074-1.213, P < .001). DeStefano et al,9 Mattila et al,10 and Wu et al12 found that this risk ratio is significant. However, Howell et al 13 and Joshipura et al11 found that this risk ratio was not significant. One of the possible explanations they provide for the negative results is that some of the
Discussion
Our results indicate that there is a statistically significant positive correlation between periodontal disease and CHD. Both the incidence and prevalence of CHD are increased in patients who are affected with periodontal disease.
Coronary heart disease is a multifactorial disease. Various risk factors such as age, sex, family history of heart disease, smoking, alcohol intake, DM, exercise, obesity, and high blood pressure play a role in the pathogenesis of CHD. Most of the studies included in
Conclusions
Our analysis suggests possible association between PD and CHD. Elevated levels of inflammatory mediators in patients with PD suggest their role in atherothrombogenesis leading to CHD. Future well-designed prospective cohort studies with uniform definitions of periodontal disease and CHD investigating the definite role of periodontal pathogen burden on the occurrence of CHD and management of patients with PD to reduce the future risk of development of CHD are necessary.
References (34)
Multiple infections in carotid atherosclerotic plaques
Am Heart J
(1999)Biases and weak associations
Prev Med
(1987)- et al.
Current methods of the US Preventive Services Task Force: a review of the process
Am J Prev Med
(2001) - et al.
Periodontal disease and risk of subsequent cardiovascular disease in US male physicians
J Am Coll Cardiol
(2001) - et al.
Assessing the relationship between dental disease and coronary heart disease in elderly US veterans
J Am Dent Assoc
(1998) - et al.
The impact of edentulousness on food and nutrient intake
J Am Dent Assoc
(1996) - et al.
Tooth loss and dietary intake
J Am Dent Assoc
(2003) - et al.
Meta-analysis of periodontal disease and risk of coronary heart disease and stroke
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2003) - et al.
Condition of teeth and periodontal tissue in patients who had suffered a heart attack (in Croatian)
Zobozdrav Vestn
(1988) - et al.
Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients
J Periodontol
(2000)