Periodontal Disease, Serum Inflammatory Markers and CHD Risk Factors

Objectives: Periodontitis is associated with higher risk of coronary heart disease (CHD). Both CHD and periodontitis have been associated with obesity and smoking. In this study we investigated the association between periodontitis and obesity, smoking and hypertension, in CHD patients. Methods: Baseline data of CHD patients aged >30, without any other systemic acute/chronic disease, recruited for a randomized clinical trial was used for this study. Periodontal parameters assessed: bleeding on probing (BOP), periodontal probing depths (PPD) and clinical attachment level (CAL). Systemic levels of hsCRP, fibrinogen and WBCs were determined. Periodontal and systemic inflammatory variables were analyzed for their association with hypertension, BMI and smoking. t-test, Chi-sq test, partial correlations and regression analysis, were used as tests of significance. Results: Among 317 study subjects; 53% patients were hypertensive, 63% obese and 40% former smokers. Periodontal and systemic inflammatory parameters were higher in hypertensive, obese and former-smoker patients. Bleeding on probing was significantly (p≤0.001) associated with hypertension and obesity. Probing depths were significantly (p≤0.001) associated with hypertension and clinical attachment levels with smoking history. Systemic hsC-reactive protein and white blood cell counts were significantly (p≤0.001) associated with hypertension. The proportion of subjects with BOP >20%, PPD ≥4mm>30%, CAL ≥3mm>30% and proportion of subjects with serum levels of CRP >3mg/L, fibrinogen >300mg/L and WBC counts of >7.00x109/L were higher in number in hypertensive, obese and former smoker groups. Conclusion: Different periodontal and systemic inflammatory parameters are significantly associated with hypertension, obesity and smoking in CHD patients.