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History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women

Year: 2017
Type: article
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 CVD in 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.
DOI: 10.1161/jaha.116.004518
Authors: Michael J. LaMonte, Robert J. Genco, Kathleen M. Hovey, Robert B. Wallace, Jo L. Freudenheim, Dominique S. Michaud, Xiaodan Mai, Lesley F. Tinker, Christian R. Salazar, Christopher A. Andrews, Wenjun Li, Charles B. Eaton, Lisa W. Martin, Jean Wactawski‐Wende
Institutions: University at Buffalo, State University of New York, University of Iowa, Tufts University, Fred Hutch Cancer Center, Albert Einstein College of Medicine, University of Michigan, University of Massachusetts Chan Medical School, Brown University, George Washington University
Language: English
Subfield: Periodontics
Field: Dentistry
Open Access status: gold
Estimated APC paid: $3,810
Funders: U.S. Department of Health and Human Services, Brigham and Women's Hospital, Ohio State University, Wake Forest University, University of Pittsburgh, MedStar Health Research Institute, National Institutes of Health, University at Buffalo, National Heart, Lung, and Blood Institute, National Cancer Institute, National Center for Advancing Translational Sciences
Awards: G1050918383, G1471908156, G1851278524, G2209176514, G3062349281, G3069585042, G3643850837, G3900787601, G4546180501, G6694253514, G700120080, G7332203415, G757750085, University of Buffalo Clinical and Translational Science Institute, Interdisciplinary Training in Cancer Epidemiology at UB, Interdisciplinary Training in Cancer Epidemiology at UB, G8606882599, G915959914
OpenAlex ID: W2598194011
FWCI: 9.434
Cites: 39
Cited by: 84
Related to: 10