TY - JOUR
T1 - Periodontal disease and coronary heart disease incidence
T2 - A systematic review and meta-analysis
AU - Humphrey, Linda L.
AU - Fu, Rongwei
AU - Buckley, David I.
AU - Freeman, Michele
AU - Helfand, Mark
N1 - Funding Information:
This research was funded by the Agency for Healthcare Research and Quality to support the work of the US Preventive Services Task Force under contract no. 290-02-0024, task order no. 2, Rockville, MD. Agency approval was required before this manuscript could be submitted for publication, but the authors are solely responsible for its content and the decision to submit it. This analysis was conducted as part of a review of non-traditional risk factors for coronary artery disease. Prior to submission, this report was reviewed by several experts in the area of cardiovascular disease epidemiology, by USPSTF project leaders, and by AHRQ staff, and revised accordingly.
PY - 2008/12
Y1 - 2008/12
N2 - BACKGROUND: Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD). OBJECTIVE: To aid the United States Preventive Services Task Force (USPSTF) in evaluating whether periodontal disease is an independent novel risk factor for incident CHD. METHODS: Studies were identified by searching Medline (1966 through March 2008) and reviewing prior systematic reviews, reference lists, and consulting experts. Prospective cohort studies that assessed periodontal disease, Framingham risk factors, and coronary heart disease incidence in the general adult population without known CHD were reviewed and quality rated using criteria developed by the USPSTF. Meta-analysis of good and fair quality studies was conducted to determine summary estimates of the risk of CHD events associated with various categories of periodontal disease. RESULTS: We identified seven articles of good or fair quality from seven cohorts. Several studies found periodontal disease to be independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis, and bone loss) ranged from 1.24 (95% CI 1.01-1.51) to 1.34 (95% CI 1.10-1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality, and method of periodontal disease assessment. CONCLUSION: Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.
AB - BACKGROUND: Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD). OBJECTIVE: To aid the United States Preventive Services Task Force (USPSTF) in evaluating whether periodontal disease is an independent novel risk factor for incident CHD. METHODS: Studies were identified by searching Medline (1966 through March 2008) and reviewing prior systematic reviews, reference lists, and consulting experts. Prospective cohort studies that assessed periodontal disease, Framingham risk factors, and coronary heart disease incidence in the general adult population without known CHD were reviewed and quality rated using criteria developed by the USPSTF. Meta-analysis of good and fair quality studies was conducted to determine summary estimates of the risk of CHD events associated with various categories of periodontal disease. RESULTS: We identified seven articles of good or fair quality from seven cohorts. Several studies found periodontal disease to be independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis, and bone loss) ranged from 1.24 (95% CI 1.01-1.51) to 1.34 (95% CI 1.10-1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality, and method of periodontal disease assessment. CONCLUSION: Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.
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U2 - 10.1007/s11606-008-0787-6
DO - 10.1007/s11606-008-0787-6
M3 - Article
C2 - 18807098
AN - SCOPUS:57249094305
SN - 0884-8734
VL - 23
SP - 2079
EP - 2086
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 12
ER -