Periodontal disease and coronary heart disease risk

Context Research has suggested a relationship between periodontal disease a nd coronary heart disease (CHD), but data on the association between these 2 common conditions are inconclusive due to the possibility of confounding. Objective To evaluate the risk of CHD in persons with periodontitis, gingiv itis, or no periodontal disease. Design Prospective cohort study. Setting The First National Health and Nutrition Examination Survey Epidemio logic Follow-up Study, conducted in 1982-1984, 1986, 1987, and 1992. Participants A total of 8032 dentate adults aged 25 to 74 years with no rep orted history of cardiovascular disease, including 1859 individuals with pe riodontitis, 2421 with gingivitis, and 3752 with healthy periodontal tissue s. Main Outcome Measure First occurrence of death from CHD or hospitalization due to CHD, or revascularization procedures, obtained from death certificat es and medical records, by baseline periodontal status. Results During follow-up, 1265 individuals had at least 1 CHD event, includ ing CHD fatality (n=468) or at least 1 hospitalization with a diagnosis of CHD (n=1022), including coronary revascularization procedures (n=155). Afte r adjustment for known cardiovascular risk factors, gingivitis was not asso ciated with CHD (hazard ratio, 1.05; 95% confidence interval. 0.88-1.26), w hile periodontitis was associated with a nonsignificant increased risk for CHD event (hazard ratio, 1.14; 95% confidence interval, 0.96-1.36). Conclusion This study did not find convincing evidence of a causal associat ion be tween periodontal disease and CHD risk.