Associations between Pharmacotherapy for Cardiovascular Diseases and Periodontitis.

The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). BACKGROUND: Xerostomia increases the risk of PD and is a side effect of some pharmacotherapies. Information about the effect of cardioprotective treatment of periodontal status is scarce. METHODS: We studied 562 dentate residents of Krakow at the age of 50 to 70 years. Information about treatment was collected using a standardized questionnaire. The pocket depth and clinical attachment level (CAL) were used to ascertain PD. Multivariate logistic regression was applied to assess the relation between cardioprotective medications and PD. RESULTS: PD was found in 74% of participants. The range of cardioprotective drug use among participants was 7% (ARBs) to 32% (beta-blockers). After adjusting for age, sex, number of teeth, smoking, and education, ASA's use was related to a lower prevalence of PD in all dentate participants (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.40-0.99). The use of ARBs and statins was found to be associated with a higher prevalence of PD in persons having ≥6 teeth (odds ratio (OR) = 3.57, 95% CI: 1.06-11.99 and OR = 1.81, 95% CI: 1.03-3.16, respectively). Further adjustment for CVD risk factors, history of coronary heart disease, and other chronic diseases did not attenuate the results. There was no significant relation between PD and the use of other cardioprotective drugs.

Relationship between past myocardial infarction, periodontal disease and Porphyromonas gingivalis serum antibodies: A case-control study.

BACKGROUND: The relationship between chronic periodontitis (CP) and increased risk for cardiovas-cular disease (CVD) is known but quantitative assessments and mechanisms are not fully understood. The aim of this study was to assess the relationship between past myocardial infarction (MI) and the severity of CP, and the level of serum antibody titer against Porphyromonas gingivalis gingipains. METHODS: The study sample consisted of 97 patients after MI and 113 high risk controls with no history of coronary heart disease (CHD) matched with age, sex and place of residence (urban vs. rural). Data on the history of CHD and presence of risk factors were collected. Periodontal status was assessed using the Community Periodontal Index (CPI), clinical attachment loss (CAL), bleeding on probing (BOP) and pocket depth. RESULTS: After adjustment for potential confounders patients with BOP = 20-50% and BOP > 50% had more than four times higher odds of past MI (OR = 4.56; 95% CI 2.03-10.27). Patients with CPI code = 4 had a three times higher odds of past MI (OR = 3.18, 95% CI 1.01-10.06). CAL ≥ 6 was related to higher odds of past MI (OR = 1.28, 95% CI 1.11-1.49). Patients with moderate antibody titer levels had an almost 3 times higher odds of past MI (OR = 2.82, 95% CI 1.02-7.84). CONCLUSIONS: There was an association between CP and past MI, which was independent of classical CVD risk factors and confirmed by an association between past MI and immunological reaction against P. gingivalis gingipains.

Association between central and peripheral blood pressure and periodontal disease in patients with a history of myocardial infarction.

INTRODUCTION: Central and peripheral blood pressure (BP) and periodontal disease (PD) are considered to be related to the risk of cardiovascular disease. However, there is scarce evidence on the association between chronic PD and BP. OBJECTIVES: The aim of the study was to assess the relation between chronic PD, antibodies against Porphyromonas gingivalis (P.g.) gingipains and central and peripheral BP in high-risk patients with previous myocardial infarction. PATIENTS AND METHODS: We examined 99 patients (71 men and 28 women) 6 to 18 months after myocardial infarction. The periodontal status was assessed using the Community Periodontal Index (CPI). BP was measured noninvasively using the Mobil-O-Graph device. Antibody titers against P.g. gingipains were determined by an enzyme-linked immunosorbent assay. The association between CPI and BP was assessed using logistic regression models. RESULTS: The mean age of participants was 60.5 ±8.7 years. After the adjustment for age, sex, smoking, diabetes, number of antihypertensive drugs, hypercholesterolemia, body mass index, and left ventricular ejection fraction, an association was found between central and peripheral BP and the CPI. Patients from the CPI 3 + 4 group were found to have almost 3 times higher odds of central BP of 130/90 mmHg or higher and more than 3 times higher odds of peripheral BP of 140/90 mmHg or higher compared with patients from the CPI 1 + 2 group. CONCLUSIONS: The severity of PD was associated with increased central and peripheral BP. The association between BP and PD may partially explain the cardiovascular risk related to chronic PD. Proteolytic activity of P.g. gingipains was not associated with BP.