Department of Medicine, Division of Preventive and Behavioral Medicine
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Diagnosis | Epidemiology | Nervous System Diseases | Pathological Conditions, Signs and Symptoms | Periodontics and Periodontology | Stomatognathic Diseases | Women's Health
BACKGROUND: Few studies have reported associations between periodontitis and cardiovascular disease (CVD) risk in older women, which is the objective of the present investigation.
METHODS AND RESULTS: Participants were 57 001 postmenopausal women ages 55 to 89 years (mean 68 years; > 85% 60 and older) who were enrolled (1993-1998) in the Women's Health Initiative Observational Study, and were without known CVD when history of periodontitis and edentulism was assessed by questionnaire at study Year-5 (1998-2003). There were 3589 incident CVD events and 3816 total deaths during a mean follow-up of 6.7 years. In multivariable analysis, periodontitis was not associated with CVD events, but was associated with higher total mortality (hazard ratio (HR)=1.12, 95% CI: 1.05-1.21). Edentulism was associated with higher age- and smoking-adjusted risks of CVD (HR=1.42, 95% CI: 1.27-1.59) and mortality (HR=1.47, 95% CI: 1.32-1.63). Further adjustment eliminated the association with CVD, but mortality remained significantly increased (HR=1.17, 95% CI: 1.02-1.33). Stratification on age, race-ethnicity, smoking, and diabetes mellitus yielded comparable results; however, edentulism was more strongly associated with CVD in women reporting > /=1 dental visit (HR=1.57) compared with (HR 1.03, interaction P=0.004) annually.
CONCLUSIONS: In community-dwelling older women, edentulism was associated with increased risks of CVD and total mortality, and presence of periodontitis, which is more prevalent than edentulism, was associated with 17% higher mortality rate. These findings suggest that improving periodontal condition of the general population could reduce overall mortality.
cardiovascular disease, epidemiology, mortality, periodontal disease, women's health
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Copyright 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
DOI of Published Version
J Am Heart Assoc. 2017 Mar 29;6(4). pii: e004518. doi: 10.1161/JAHA.116.004518. Link to article on publisher's site
Journal of the American Heart Association
LaMonte MJ, Genco RJ, Hovey KM, Wallace RB, Freudenheim JL, Michaud DS, Mai X, Tinker L, Salazar CR, Andrews CA, Li W, Eaton C, Martin LW, Wactawski-Wende J. (2017). History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women. University of Massachusetts Medical School Faculty Publications. https://doi.org/10.1161/JAHA.116.004518. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/1306
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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Cardiology Commons, Cardiovascular Diseases Commons, Clinical Epidemiology Commons, Diagnosis Commons, Epidemiology Commons, Nervous System Diseases Commons, Pathological Conditions, Signs and Symptoms Commons, Periodontics and Periodontology Commons, Stomatognathic Diseases Commons, Women's Health Commons