Persisting Chronic Periodontal Disease as a Risk Factor for Cardiovascular Disease: A Nationwide Population‐Based Cohort Study

IF 5.8 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Jung‐Hyun Park, Gwang Hyun Leem, Jin‐Woo Kim, Tae‐Jin Song
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Abstract

AimsEpidemiological studies have consistently established a positive association between periodontal disease (PD) and cardiovascular disease (CVD). However, large‐scale investigations exploring the impact of changes in PD status on CVD risk are scarce. This study aimed to investigate the association between the dynamics in PD and the risk of incident CVD in a nationally representative population.MethodsUtilising data from the Korean National Health Insurance Service, a cohort of 1,242,570 participants who underwent oral health exams in 2003 and a follow‐up exam in 2005–2006 was analysed. Participants were categorized into groups based on changes in PD status: absent, improvement, onset and persistent. Cox proportional hazard models were employed to assess the multivariate‐adjusted hazard ratios (HRs) for composite CVD outcomes, including death, myocardial infarction and stroke.ResultsOver a mean follow‐up of 14.4 years, 79,810 (6.4%) cases of composite CVD occurred, including 14,296 (1.2%) myocardial infarctions, 3247 (0.3%) hemorrhagic strokes and 8900 (0.7%) ischemic strokes. Individuals with persistent PD showed the highest risk of CVD (HR: 1.04, 95% CI: 1.03–1.06, p < 0.001). In the pairwise comparisons, the PD improvement group exhibited a lower composite CVD risk than the PD persistent group (HR: 0.97, 95% CI: 0.96–0.99, p = 0.010); similarly, the PD onset group showed a lower risk than the PD persistent group (HR: 0.94, 95% CI: 0.93–0.96, p < 0.001). This pattern was consistent in the risk of death, with both the PD improvement and PD onset groups showing a lower risk of death than the PD persistent group.ConclusionThis study suggests the dynamic nature of PD as a potential modifiable risk factor for CVD. Individuals with chronically persistent PD showed an elevated incidence risk of CVD, emphasizing the importance of managing PD in preventive strategies.
持续性慢性牙周病是心血管疾病的危险因素:一项基于全国人群的队列研究
目的流行病学研究一致确立了牙周病(PD)与心血管疾病(CVD)之间的正相关关系。然而,研究PD状态变化对心血管疾病风险影响的大规模调查很少。本研究旨在调查PD动态与全国代表性人群发生心血管疾病风险之间的关系。方法利用韩国国民健康保险服务中心的数据,对2003年接受口腔健康检查和2005-2006年随访检查的1,242,570名参与者进行分析。参与者根据PD状态的变化分为:缺失、改善、发病和持续。采用Cox比例风险模型评估复合心血管疾病结局(包括死亡、心肌梗死和卒中)的多变量校正风险比(hr)。结果平均随访14.4年,共发生复合心血管疾病79810例(6.4%),其中心肌梗死14296例(1.2%),出血性脑卒中3247例(0.3%),缺血性脑卒中8900例(0.7%)。持续性PD患者患CVD的风险最高(HR: 1.04, 95% CI: 1.03-1.06, p <;0.001)。在两两比较中,PD改善组的综合心血管疾病风险低于PD持续性组(HR: 0.97, 95% CI: 0.96-0.99, p = 0.010);同样,PD发病组的风险低于PD持续性组(HR: 0.94, 95% CI: 0.93-0.96, p <;0.001)。这种模式在死亡风险上是一致的,PD改善组和PD发病组的死亡风险都低于PD持续性组。结论本研究提示PD的动态特性是CVD的潜在可改变危险因素。慢性持续性PD患者患CVD的风险升高,这强调了在预防策略中管理PD的重要性。
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来源期刊
Journal of Clinical Periodontology
Journal of Clinical Periodontology 医学-牙科与口腔外科
CiteScore
13.30
自引率
10.40%
发文量
175
审稿时长
3-8 weeks
期刊介绍: Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.
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