American Heart Journal
Volume 151, Issue 5 , Pages 977-984 , May 2006

Periodontal infections cause changes in traditional and novel cardiovascular risk factors: Results from a randomized controlled clinical trial

  • Francesco D'Aiuto, DMD, PhD

      Affiliations

    • Department of Periodontology and Eastman Clinical Investigation Centre, University College London (UCL), London, United Kingdom
    • ,
  • Mohamed Parkar, BSc, MPhil

      Affiliations

    • Department of Periodontology and Eastman Clinical Investigation Centre, University College London (UCL), London, United Kingdom
    • ,
  • Luigi Nibali, DMD

      Affiliations

    • Department of Periodontology and Eastman Clinical Investigation Centre, University College London (UCL), London, United Kingdom
    • ,
  • Jean Suvan, RDH, MSc

      Affiliations

    • Department of Periodontology and Eastman Clinical Investigation Centre, University College London (UCL), London, United Kingdom
    • ,
  • Jan Lessem, MD

      Affiliations

    • Department of Periodontology and Eastman Clinical Investigation Centre, University College London (UCL), London, United Kingdom
    • ,
  • Maurizio S. Tonetti, DMD, PhD

      Affiliations

    • Department of Periodontology and Eastman Clinical Investigation Centre, University College London (UCL), London, United Kingdom
    • Division of Periodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT
    • Corresponding Author InformationReprint requests: Maurizio S. Toretti, Division of Periodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030.

Received 21 December 2004 ,Accepted 9 June 2005.

References 

  1. O'Reilly PG, Claffey NM. A history of oral sepsis as a cause of disease. Periodontol 2000. 2000;23:13–18
  2. Beck JD, Offenbacher S. The association between periodontal diseases and cardiovascular diseases: a state-of-the-science review. Ann Periodontol. 2001;6:9–15
  3. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: a two-way relationship. Ann Periodontol. 1998;3:51–61
  4. Madianos PN, Lieff S, Murtha AP, et al. Maternal periodontitis and prematurity. Part II: maternal infection and fetal exposure. Ann Periodontol. 2001;6:175–182
  5. Scannapieco FA, Rethman MP. The relationship between periodontal diseases and respiratory diseases. Dent Today. 2003;22:79–83
  6. Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease, and stroke. A systematic review. Ann Periodontol. 2003;8:38–53
  7. Madianos PN, Bobetsis GA, Kinane DF. Is periodontitis associated with an increased risk of coronary heart disease and preterm and/or low birth weight births?. J Clin Periodontol. 2002;29(Suppl 3):22–36
  8. D'Aiuto F, Nibali L, Parkar M, et al. Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. J Dent Res. 2005;84:269–273
  9. Angeli F, Verdecchia P, Pellegrino C, et al. Association between periodontal disease and left ventricle mass in essential hypertension. Hypertension. 2003;41:488–492
  10. Taguchi A, Sanada M, Suei Y, et al. Tooth loss is associated with an increased risk of hypertension in postmenopausal women. Hypertension. 2004;43:1297–1300
  11. Paquette D, Santucci E. A pharmacokinetic study of a locally delivered minocycline therapeutic system (MPTS). J Clin Periodontol. 2000;27(Suppl 1):28
  12. O'Neill H, O'Brien E, Stanton A, et al. The suitability of an automated blood pressure measuring device—the Omron HEM-705CP—in a large multicentre study: the ASCOT study. J Hum Hypertens. 2001;15(Suppl 1):S83–S85
  13. Hingorani AD, Vallance P. A simple computer program for guiding management of cardiovascular risk factors and prescribing. BMJ. 1999;318:101–105
  14. Tilley BC, Pillemer SR, Heyse SP, et al. Global statistical tests for comparing multiple outcomes in rheumatoid arthritis trials. MIRA Trial Group. Arthritis Rheum. 1999;42:1879–1888
  15. Tilley BC, Marler J, Geller NL, et al. Use of a global test for multiple outcomes in stroke trials with application to the National Institute of Neurological Disorders and Stroke t-PA Stroke Trial. Stroke. 1996;27:2136–2142
  16. Anderson JL, Muhlestein JB, Carlquist J, et al. Randomized secondary prevention trial of azithromycin in patients with coronary artery disease and serological evidence for Chlamydia pneumoniae infection: the Azithromycin in Coronary Artery Disease: elimination of Myocardial Infection with Chlamydia (ACADEMIC) study. Circulation. 1999;99:1540–1547
  17. Slade GD, Offenbacher S, Beck JD, et al. Acute-phase inflammatory response to periodontal disease in the US population. J Dent Res. 2000;79:49–57
  18. Slade GD, Ghezzi EM, Heiss G, et al. Relationship between periodontal disease and C-reactive protein among adults in the atherosclerosis risk in communities study. Arch Intern Med. 2003;163:1172–1179
  19. Da Silva O, Ohlsson A, Kenyon C. Accuracy of leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis: a critical review. Pediatr Infect Dis J. 1995;14:362–366
  20. Brown DW, Ford ES, Giles WH, et al. Associations between white blood cell count and risk for cerebrovascular disease mortality: NHANES II Mortality Study, 1976-1992. Ann Epidemiol. 2004;14:425–430
  21. Haim M, Boyko V, Goldbourt U, et al. Predictive value of elevated white blood cell count in patients with preexisting coronary heart disease: the Bezafibrate Infarction Prevention Study. Arch Intern Med. 2004;164:433–439
  22. Ohshita K, Yamane K, Hanafusa M, et al. Elevated white blood cell count in subjects with impaired glucose tolerance. Diabetes Care. 2004;27:491–496
  23. D'Aiuto F, Parkar M, Andreou G, et al. Periodontitis and atherogenesis: causal association or simple coincidence? A pilot intervention study. J Clin Periodontol. 2004;31:402–411
  24. Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 1986;256:2823–2828
  25. Leinonen M, Saikku P. Evidence for infectious agents in cardiovascular disease and atherosclerosis. Lancet Infect Dis. 2002;2:11–17
  26. Ogawa Y, Imaki M, Yoshida Y, et al. Epidemiological study on the relationship between hypertension and dental disease in Japanese factory workers. Sangyo Eiseigaku Zasshi. 1998;40:235–240
  27. Amar S, Gokce N, Morgan S, et al. Periodontal disease is associated with brachial artery endothelial dysfunction and systemic inflammation. Arterioscler Thromb Vasc Biol. 2003;23:1245–1249
  28. Hingorani AD, Cross J, Kharbanda RK, et al. Acute systemic inflammation impairs endothelium-dependent dilatation in humans. Circulation. 2000;102:994–999
  29. Yoshizumi M. Oxidative stress and vascular dysfunction in hypertension. Nippon Rinsho. 2004;62(Suppl 3):43–47
  30. Gryglewski RJ, Palmer RM, Moncada S. Superoxide anion is involved in the breakdown of endothelium-derived vascular relaxing factor. Nature. 1986;320:454–456
  31. Taddei S, Virdis A, Mattei P, et al. Defective l-arginine–nitric oxide pathway in offspring of essential hypertensive patients. Circulation. 1996;94:1298–1303
  32. Saito M, Ishimitsu T, Minami J, et al. Relations of plasma high-sensitivity C-reactive protein to traditional cardiovascular risk factors. Atherosclerosis. 2003;167:73–79
  33. Bautista LE. Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence. J Hum Hypertens. 2003;17:223–230
  34. Fernandez-Real JM, Ricart W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev. 2003;24:278–301
  35. Yudkin JS, Juhan-Vague I, Hawe E, et al. Low-grade inflammation may play a role in the etiology of the metabolic syndrome in patients with coronary heart disease: the HIFMECH study. Metabolism. 2004;53:852–857
  36. Hayashi K, Takada K, Hirasawa M. Clinical and microbiological effects of controlled-release local delivery of minocycline on periodontitis in dogs. Am J Vet Res. 1998;59:464–467
  37. Yeom HR, Park YJ, Lee SJ, et al. Clinical and microbiological effects of minocycline-loaded microcapsules in adult periodontitis. J Periodontol. 1997;68:1102–1109
  38. D'Aiuto F, Parkar M, Andreou G, et al. Periodontitis and systemic inflammation: control of the local infection is associated with a reduction in serum inflammatory markers. J Dent Res. 2004;83:156–160
  39. Greenwald RA, Moak SA, Ramamurthy NS. Tetracyclines suppress matrix metalloproteinase activity in adjuvant arthritis and in combination with flurbiprofen, ameliorate bone damage. J Rheumatol. 1992;19:927–938
  40. Langevitz P, Livneh A, Bank I, et al. Benefits and risks of minocycline in rheumatoid arthritis. Drug Saf. 2000;22:405–414
  41. Ridker PM, Morrow DA. C-Reactive protein, inflammation, and coronary risk. Cardiol Clin. 2003;21:315–325

 This study was supported by a donation from Orapharma and by the Periodontal Research Fund of the Eastman Dental Institute. The sponsors of the study had a role in study design, but not in data collection, data analysis, data interpretation, or in the writing of the report. F.D. and L.N. are supported by a fellowship from the Italian Society of Periodontology and the European Union.

PII: S0002-8703(05)00631-9

doi: 10.1016/j.ahj.2005.06.018

American Heart Journal
Volume 151, Issue 5 , Pages 977-984 , May 2006

Article Tools

* Image Usage & Resolution