Atherosclerosis and chronic periodontitis – associated pathology or pathogenic relationship?

Introduction: Infections and also some inflammation markers are probable related to the pathogenic process of atherosclerosis. The aim of this study is to evaluate the interrelationship between subclinical and clinical atherosclerosis and chronic periodontitis (CP), the possible common risk and infl ammatory factors. Methods: We selected two equal, homogeneous groups (96 patients/lot) of people, aged 50 – 70 years, without (lot A), respectively with (lot B) subclinical or/and clinical manifestations of systemic (coronary, neurological, peripheral) atheromatosis. We noted demographic, socio-economic data, blood pressure (BP), the presence of diabetes, serum lipids, fi brinogen, C – reactive protein (CRP) and the echocardiography, carotid and peripheral vascular ultrasound, ankle-arm index data. In all the patients, dental examination was performed in order to assess the presence of chronic periodontitis for loss attachment and the presence of periodontal pockets (>3 mm). Results: Comparing the two lots we found in lot B the presence of family history (p = 0.020), smoking (p <0.001), a lower diastolic blood pressure (p <0.01), higher pulse pressure (p <0.001), high cholesterol (p < 0.01), increased CRP (8% vs 21%) in relation with smoking (p = 0.03) and family history (p = 0.045). CP was confirmed in 91.1% of the total patients (94.7% in the group with atherosclerosis, and 70.59 % without atherosclerosis, p = 0.018). Persons with PC were mainly between 61-70 years and men, 8.5% with poor socioeconomic status, 31.45% smokers (p <0.005), lower diastolic BP (p = 0.07), increased pulse pressure (p = 0.009), low HDL cholesterol (p <0.0001). Conclusions: Association between atherosclerosis and chronic periodontitis is indisputable (94%), as well as the presence of common risk factors: age, sex, smoking, diastolic BP values and diabetes; family history suggests a possible associated genetic mechanism; also the presence of environmental factors in CP is suggested by a poor socioeconomic status. The moderate inflammation proven by values of CRP in CP is most likely to be the connection element for initiation, maintenance or aggravation of vascular atherosclerosis.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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