Risk of incident cardiovascular disease in people with periodontal disease: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of longitudinal cohort studies
PubMed 33124761 · doi:10.1002/cre2.336
What was done
A systematic review and meta-analysis searched Medline, EMBASE, and Cochrane databases through October 9, 2019, for randomized controlled trials and longitudinal cohort studies assessing incident cardiovascular disease (CVD) in people with periodontal disease (PD) versus non-PD controls. Measured outcomes included any CVD, myocardial infarction, coronary heart disease (CHD), and stroke. Thirty-two longitudinal cohort studies met inclusion criteria, and 30 were pooled in meta-analysis and meta-regression to evaluate overall CVD risk and modifiers including diagnostic method, disease severity, sex, and region.
What was found
Risk of incident CVD was significantly higher in individuals with PD compared to non-PD controls (relative risk [RR] 1.20, 95% CI: 1.14–1.26). Risk did not differ significantly by diagnostic method (clinical vs. self-report: RR 0.97, 95% CI: 0.87–1.07). Elevated CVD risk was observed in men (RR 1.16, 95% CI: 1.08–1.25) and participants with severe PD (RR 1.25, 95% CI: 1.15–1.35). By subtype, stroke showed the highest association (RR 1.24, 95% CI: 1.12–1.38), followed by CHD (RR 1.14, 95% CI: 1.08–1.21).
Why it matters
This study quantitatively synthesizes longitudinal cohort data to confirm a modest prospective association between periodontal disease and incident cardiovascular events, highlighting higher risks in severe periodontal disease and stroke.
Limits
All included studies were observational cohorts rather than randomized intervention trials, precluding causal inference. The abstract does not provide total participant count, follow-up durations, or measures of between-study heterogeneity.
Cited by
- supports Periodontal pathogens in the mouth can cause heart attacks, brain damage, increased risk for stroke, and preterm birth in pregnancy.