Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association
- PMID: 22514251
- DOI: 10.1161/CIR.0b013e31825719f3
Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association
Abstract
A link between oral health and cardiovascular disease has been proposed for more than a century. Recently, concern about possible links between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) has intensified and is driving an active field of investigation into possible association and causality. The 2 disorders share several common risk factors, including cigarette smoking, age, and diabetes mellitus. Patients and providers are increasingly presented with claims that PD treatment strategies offer ASVD protection; these claims are often endorsed by professional and industrial stakeholders. The focus of this review is to assess whether available data support an independent association between ASVD and PD and whether PD treatment might modify ASVD risks or outcomes. It also presents mechanistic details of both PD and ASVD relevant to this topic. The correlation of PD with ASVD outcomes and surrogate markers is discussed, as well as the correlation of response to PD therapy with ASVD event rates. Methodological issues that complicate studies of this association are outlined, with an emphasis on the terms and metrics that would be applicable in future studies. Observational studies to date support an association between PD and ASVD independent of known confounders. They do not, however, support a causative relationship. Although periodontal interventions result in a reduction in systemic inflammation and endothelial dysfunction in short-term studies, there is no evidence that they prevent ASVD or modify its outcomes.
Comment in
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Periodontal disease, cardiovascular disease, the American Heart Association, the American Academy of Periodontology, and the rooster syndrome.Evid Based Dent. 2012 Jun;13(2):34, 36. doi: 10.1038/sj.ebd.6400851. Evid Based Dent. 2012. PMID: 22722406 No abstract available.
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Will periodontal treatment prevent heart disease and stroke?J Evid Based Dent Pract. 2012 Dec;12(4):212-5. doi: 10.1016/j.jebdp.2012.09.013. J Evid Based Dent Pract. 2012. PMID: 23177502 No abstract available.
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