Document Type
Journal Article
Publication Date
3-29-2017
Journal
J Am Heart Assoc
Volume
6
Issue
4
DOI
10.1161/JAHA.116.004518
Abstract
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 CVDin women reporting ≥1 dental visit (HR=1.57) compared with <1 visit (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.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
APA Citation
LaMonte, M., Genco, R., Hovey, K., Wallace, R., Freudenheim, J., Michaud, D., Mai, X., Tinker, L., Salazar, C., Andrews, C., Li, W., Eaton, C., Martin, L., & Wactawski-Wende, J. (2017). History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women.. J Am Heart Assoc, 6 (4). http://dx.doi.org/10.1161/JAHA.116.004518
Peer Reviewed
1
Open Access
1
Included in
Cardiology Commons, Cardiovascular Diseases Commons, Periodontics and Periodontology Commons
Comments
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 CVDin women reporting ≥1 dental visit (HR=1.57) compared with <1 visit (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.