Chronic periodontitis and coronary heart disease in middle aged men

Objectives: To investigate any association between coronary heart disease (CHD) and periodontitis in males in Northern Ireland (NI). Methods: Cases were males aged over 40 years with coronary artery disease evidenced by >50% narrowing of at least one coronary artery on angiography or Thallium radioisotope scanning. Controls were age-matched males, randomly drawn from the general population of our hospital’s catchment area. Each subject had a clinical periodontal examination and completed a detailed socio-demographic questionnaire. Subjects with pocketing of 6mm or deeper were ajudged to have chronic periodontitis (CP). Logistic regression was used for multivariate modelling. Results: There were 92 cases of mean age 56.7 (SD 6.3) yrs and 79 controls of mean age 58.2 (6.7) yrs, (t= 1.47, P=0.14). A higher proportion of the cases (30%) than controls (11%) had CP, (Chi square 9.1, P = 0.003). The unadjusted odds ratio (OR) for the association of CHD with CP was 3.39 (95% C.I. 1.44-8.01, P= 0.005). Adjustment for ‘ever smoking’ reduced the OR to 3.01 (1.19-7.59, P= 0.02). The incorporation of various lifestyle factors into the multivariate model, (including academic achievement, alcohol use, regular exercise, daily relaxation and the ability to maintain bodyweight) strengthened the association between CHD and periodontal disease (OR = 3.64, 1.39-9.50, P= 0.008). The addition of other measures of periodontal status, which included plaque and bleeding on probing, attenuated the odds ratio to 2.91 (0.97- 8.66, P=0.06). Conclusions: Clinical evidence of periodontitis was associated with an increased risk of CHD in this sample of Northern Ireland males. Supported by the Northern Ireland Chest Heart and Stroke Association.