Disclosures: The authors report no relevant financial disclosures.
January 19, 2022
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Periodontal disease diagnosis tied to CVD risk

Disclosures: The authors report no relevant financial disclosures.
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Adults with a recorded diagnosis of a periodontal disease, including gingivitis and periodontitis, are more likely to develop CVD and other chronic diseases compared with patients without a diagnosis, researchers reported.

Dawit T. Zemedikun

Periodontal disease leads to a reduction in quality of life and results in a systemic proinflammatory state, which is implicated in the etiology of chronic diseases, Dawit T. Zemedikun, PhD, a research fellow in medical statistics and econometrics at University of Birmingham College of Medical and Dental Sciences, United Kingdom, and colleagues wrote in the study background. A high prevalence of periodontal disease could translate to a substantial burden of morbidity and associated mortality, they noted.

Graphical depiction of data presented in article
Data were derived from Zemedikun DT, et al. BMJ Open. 2021;doi:10.1136/bmjopen-2020-048296.

“Our study provides evidence that periodontal diseases are significantly associated with the development of ill mental health, cardiovascular, cardiometabolic and autoimmune diseases,” Zemedikun told Healio. “There is a need to tackle risk factors to prevent and detect gingival inflammation and its associated consequences.”

Increased risk with exposure

In a population-based, retrospective study, Zemedikun and colleagues analyzed electronic medical records data from 64,379 adults with a general practitioner-recorded diagnosis of periodontal disease (60,995 with gingivitis and 3,384 with periodontitis) from 1995 to January 2019, using IQVIA Medical Research Data. Exposed patients were matched by age, sex, deprivation and registration date with 251,161 unexposed patients. Median age at cohort entry was 45 years; median follow-up time was 3.4 years.

The findings were published in BMJ Open.

At baseline, patients with a diagnosis of periodontal disease were 43% more likely to have a diagnosis of CVD compared with unexposed patients (adjusted OR = 1.43; 95% CI, 1.38-1.48), 16% more likely to have cardiometabolic disease (aOR = 1.16; 95% CI, 1.13-1.19), 33% more likely to have autoimmune disease (aOR = 1.33; 95% CI, 1.28-1.37) and 79% more likely to have a mental health condition (aOR = 1.79; 95% CI, 1.75-1.83).

During follow-up, patients with a diagnosis of periodontal disease but without a preexisting outcome of interest at baseline were 18% more likely to develop CVD (aHR = 1.18; 95%, CI 1.13-1.23), 7% more likely to develop cardiometabolic disease (aHR = 1.07; 95% CI, 1.03-1.1), 33% more likely to develop autoimmune disease (HR = 1.33; 95% CI 1.26-1.4) and 37% more likely to develop a mental health condition (aHR = 1.37; 95% CI, 1.33-1.42) compared with the unexposed group.

‘Effective communication’ needed

The researchers noted that there is likely an under-recording of periodontal diseases in the data set and the findings may not reflect the true effect size “and are likely to be an underestimate.”

“The research findings have important implication for patients and the health care system by highlighting the need for effective communication between dental and other health care professionals to ensure patients obtain an effective treatment plan targeting both oral and extra-oral health to improve current health and reduce the risk for future ill health,” Zemedikun told Healio. “A causal inference study may be needed to establish any evidence of causation by accounting also for genetic and other unobserved confounders.”

Previous research has demonstrated an association between periodontal disease and increased CV risk. As Healio previously reported, data published in Hypertension showed that, compared with controls, people with periodontitis presented with higher mean differences in systolic BP and diastolic BP. Further, periodontitis diagnosis was associated with greater odds of systolic BP of at least 140 mm Hg compared with controls.

For more information:

Dawit T. Zemedikun, PhD, can be reached at d.t.zemedikun@bham.ac.uk; Twitter: @dawitzem.