Heart disease associated with oral health – studies of women and serological factors

A new study from Karolinska Institutet in Sweden shows, for the first time, an association between coronary heart disease and oral health in women. Recent results have also shown that serological factors, might provide insight into the reported epidemiological association between periodontitis and cardiovascular disease.

Cardiovascular disease (CVD) is the leading cause of death in the Western industrialized world. Classic risk factors such as smoking, obesity and high blood lipids do not explain all clinical and epidemiological features of CVD. Chronic inflammation has been suggested as a possible “unknown” risk factor. However, the chronic inflammatory disease periodontitis, has only recently been found to be associated to CVD.

A new study from Karolinska Institutet shows, for the first time, an association between coronary heart disease (CHD) and oral health in women. A group of 187 female patients with CHD had fewer remaining teeth (P<0.001) and more pathological periodontal pockets (P=0.002) compared to a control group. Dentures were more frequent (27% vs. 6%) as was edentulousness (10.5% vs. 0%) in the CHD group compared to the controls. In another recent study from Karolinska Institutet risk factors for CVD were found in plasma from patients with periodontitis. Plasma levels of markers for arteriosclerosis and indices of inflammation in 50 patients with severe periodontitis were compared with those in 46 healthy cases. Total cholesterol levels were similar in the two groups, whereas levels of high density lipoproteins (HDL) were lower (P=0.007) and levels of C-reactive protein (CRP) were higher in the patient group. This is important, as both HDL and CRP are accepted risk factors for arteriosclerosis. Plasma levels of bacterial antigen specific IgA anti-Hsp60 antibodies were also lower in the patient group (P=0.0001). These serological differences might provide insight into the reported epidemiological association between periodontitis and CVD. A possible mechanism behind the reported association could be the release of bacteria, bacterial products or pro-inflammatory cytokines from the periodontal lesions into the blood stream.