Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

Association of cardiovascular health and periodontitis: a population-based study

Authors: Haitao Qu, Shengnan Zhang

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

There is a strong association between cardiovascular disease (CVD) and periodontitis. This study utilized the Life Essentials 8 (LE8) score, a composite measure of cardiovascular health (CVH), to elucidate the relationship between CVH and periodontitis.

Methods

Data from 8,649 nationally representative participants in the National Health and Nutrition Examination Survey (NHANES) were analyzed. The independent variable in our study was the CVH score (a higher CVH score indicates better cardiovascular health), and the dependent variable was the presence or absence of periodontitis. The association between CVH and periodontitis was investigated using weighted multivariable logistic regression models and restricted cubic spline (RCS). We controlled for potential confounders such as age, sex, race, education, and socioeconomic status to minimize bias.

Results

There was a negative association between the total CVH score and the odds of periodontitis. After adjusting for all covariates, a 10-point increase in total CVH score was associated with a 10% lower in the odds of periodontitis [0.90 (0.87, 0.93)]. Participants with a higher CVH had 40% lower odds of periodontitis compared with those with a lower CVH. Socioeconomic status (education and income) modified this association (P for interaction < 0.05).

Conclusion

Our study suggests that better cardiovascular health, as indicated by higher CVH scores, is associated with a reduced likelihood of periodontitis among US adults. The relationship between CVH and periodontitis appears to be influenced by socioeconomic status, emphasizing the need for targeted interventions in populations with lower socioeconomic status.
Appendix
Available only for authorised users
Literature
1.
Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, Greenlund K, Daniels S, Nichol G, Tomaselli GF, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation. 2010;121(4):586–613.CrossRefPubMed
2.
Sun J, Li Y, Zhao M, Yu X, Zhang C, Magnussen CG, Xi B. Association of the American Heart Association’s new Life’s essential 8 with all-cause and cardiovascular disease-specific mortality: prospective cohort study. BMC Med. 2023;21(1):116.CrossRefPubMedPubMedCentral
3.
Ma H, Wang X, Xue Q, Li X, Liang Z, Heianza Y, Franco OH, Qi L. Cardiovascular Health and Life Expectancy among adults in the United States. Circulation. 2023;147(15):1137–46.CrossRefPubMed
4.
Wang X, Ma H, Li X, Heianza Y, Manson JE, Franco OH, Qi L. Association of Cardiovascular Health with Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK adults. JAMA Intern Med. 2023;183(4):340–9.CrossRefPubMed
5.
Shetty B, Fazal I, Khan SF, Nambiar M, Prasad DKI, Raj R. Association between cardiovascular diseases and periodontal disease: more than what meets the eye. Drug Target Insights. 2023;17:31–8.CrossRefPubMedPubMedCentral
6.
Sumayin Ngamdu K, Mallawaarachchi I, Dunipace EA, Chuang LH, Jafri SH, Shah NR, Jeong YN, Morrison AR, Bhatt DL. Association between Periodontal Disease and Cardiovascular Disease (from the NHANES). Am J Cardiol. 2022;178:163–8.CrossRefPubMed
7.
Nesse W, Dijkstra PU, Abbas F, Spijkervet FK, Stijger A, Tromp JA, van Dijk JL, Vissink A. Increased prevalence of cardiovascular and autoimmune diseases in periodontitis patients: a cross-sectional study. J Periodontol. 2010;81(11):1622–8.CrossRefPubMed
8.
Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, Listl S, Celeste RK, Guarnizo-Herreño CC, Kearns C, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249–60.CrossRefPubMed
9.
Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, Rengo G. Periodontal Disease: a risk factor for diabetes and Cardiovascular Disease. Int J Mol Sci 2019, 20(6).
10.
Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D’Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, et al. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020;47(3):268–88.CrossRefPubMedPubMedCentral
11.
Tonetti MS, Van Dyke TE. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and systemic diseases. J Periodontol. 2013;84(4 Suppl):24–9.
12.
Febbraio M, Roy CB, Levin L. Is there a causal link between Periodontitis and Cardiovascular Disease? A concise review of recent findings. Int Dent J. 2022;72(1):37–51.CrossRefPubMed
13.
Zhang Y, Liu M, Xie R. Associations between cadmium exposure and whole-body aging: mediation analysis in the NHANES. BMC Public Health. 2023;23(1):1675.CrossRefPubMedPubMedCentral
14.
Zhang Y, Wu H, Li C, Liu C, Liu M, Liu X, Yin Q, Li X, Xie R. Associations between weight-adjusted waist index and bone mineral density: results of a nationwide survey. BMC Endocr Disord. 2023;23(1):162.CrossRefPubMedPubMedCentral
15.
Xie R, Liu Y, Wang J, Zhang C, Xiao M, Liu M, Zhang Y. Race and gender differences in the associations between Cadmium exposure and bone Mineral Density in US adults. Biol Trace Elem Res. 2023;201(9):4254–61.CrossRefPubMed
16.
Zhang J, Chen G, Habudele Z, Wang X, Cai M, Li H, Gao Y, Lip GYH, Lin H. Relation of Life’s Essential 8 to the Genetic Predisposition for Cardiovascular Outcomes and All-cause Mortality: Results from a National Prospective Cohort. Eur J Prev Cardiol 2023.
17.
Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, et al. Life’s essential 8: updating and enhancing the American Heart Association’s construct of Cardiovascular Health: a Presidential Advisory from the American Heart Association. Circulation. 2022;146(5):e18–e43.CrossRefPubMedPubMedCentral
18.
19.
Vu GT, Shakib S, King C, Gurupur V, Little BB. Association between uncontrolled diabetes and periodontal disease in US adults: NHANES 2009–2014. Sci Rep. 2023;13(1):16694.CrossRefPubMedPubMedCentral
20.
Xie R, Liu L, Liu C, Xie S, Huang X, Zhang Y. Associations of ethylene oxide exposure and Life’s Essential 8. Environ Sci Pollut Res Int 2023.
21.
Mahemuti N, Zou J, Liu C, Xiao Z, Liang F, Yang X. Urinary albumin-to-creatinine ratio in normal range, Cardiovascular Health, and all-cause mortality. JAMA Netw Open. 2023;6(12):e2348333.CrossRefPubMedPubMedCentral
22.
Xie R, Ning Z, Xiao M, Li L, Liu M, Zhang Y. Dietary inflammatory potential and biological aging among US adults: a population-based study. Aging Clin Exp Res. 2023;35(6):1273–81.CrossRefPubMed
23.
Xie R, Zhang Y. Associations between dietary flavonoid intake with hepatic steatosis and fibrosis quantified by VCTE: evidence from NHANES and FNDDS. Nutr Metab Cardiovasc Dis. 2023;33(6):1179–89.CrossRefPubMed
24.
Xie R, Zhang Y. Association between 19 dietary fatty acids intake and rheumatoid arthritis: results of a nationwide survey. Prostaglandins Leukot Essent Fat Acids. 2023;188:102530.CrossRef
25.
Tang K, Wu Y, Zheng Q, Chen X. Bibliometric research on analysis of links between periodontitis and cardiovascular diseases. Front Cardiovasc Med. 2023;10:1255722.CrossRefPubMedPubMedCentral
26.
Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Risk of incident cardiovascular disease in people with periodontal disease: a systematic review and meta-analysis. Clin Exp Dent Res. 2021;7(1):109–22.CrossRefPubMed
27.
Rydén L, Buhlin K, Ekstrand E, de Faire U, Gustafsson A, Holmer J, Kjellström B, Lindahl B, Norhammar A, Nygren Å, et al. Periodontitis increases the risk of a first myocardial infarction: a Report from the PAROKRANK Study. Circulation. 2016;133(6):576–83.CrossRefPubMed
28.
Aarabi G, Eberhard J, Reissmann DR, Heydecke G, Seedorf U. Interaction between periodontal disease and atherosclerotic vascular disease–fact or fiction? Atherosclerosis. 2015;241(2):555–60.CrossRefPubMed
29.
Nepomuceno R, Pigossi SC, Finoti LS, Orrico SRP, Cirelli JA, Barros SP, Offenbacher S, Scarel-Caminaga RM. Serum lipid levels in patients with periodontal disease: a meta-analysis and meta-regression. J Clin Periodontol. 2017;44(12):1192–207.CrossRefPubMed
30.
Ferreira RO, Corrêa MG, Magno MB, Almeida A, Fagundes NCF, Rosing CK, Maia LC, Lima RR. Physical activity reduces the prevalence of Periodontal Disease: systematic review and Meta-analysis. Front Physiol. 2019;10:234.CrossRefPubMedPubMedCentral
31.
Schultz WM, Kelli HM, Lisko JC, Varghese T, Shen J, Sandesara P, Quyyumi AA, Taylor HA, Gulati M, Harold JG, et al. Socioeconomic Status and Cardiovascular outcomes: challenges and interventions. Circulation. 2018;137(20):2166–78.CrossRefPubMedPubMedCentral
32.
33.
Tang M, Liu M, Zhang Y, Xie R. Association of family income to poverty ratio and vibration-controlled transient elastography quantified degree of hepatic steatosis in U.S. adolescents. Front Endocrinol (Lausanne). 2023;14:1160625.CrossRefPubMed
34.
Ford PJ, Gemmell E, Chan A, Carter CL, Walker PJ, Bird PS, West MJ, Cullinan MP, Seymour GJ. Inflammation, heat shock proteins and periodontal pathogens in atherosclerosis: an immunohistologic study. Oral Microbiol Immunol. 2006;21(4):206–11.CrossRefPubMed
35.
Holmstrup P, Damgaard C, Olsen I, Klinge B, Flyvbjerg A, Nielsen CH, Hansen PR. Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician. J Oral Microbiol. 2017;9(1):1332710.CrossRefPubMedPubMedCentral
36.
Aarabi G, Zeller T, Seedorf H, Reissmann DR, Heydecke G, Schaefer AS, Seedorf U. Genetic susceptibility contributing to Periodontal and Cardiovascular Disease. J Dent Res. 2017;96(6):610–7.CrossRefPubMed
37.
Xie R, Liu X, Wu H, Liu M, Zhang Y. Associations between systemic immune-inflammation index and abdominal aortic calcification: results of a nationwide survey. Nutr Metab Cardiovasc Dis. 2023;33(7):1437–43.CrossRefPubMed
38.
Munz M, Richter GM, Loos BG, Jepsen S, Divaris K, Offenbacher S, Teumer A, Holtfreter B, Kocher T, Bruckmann C, et al. Genome-wide association meta-analysis of coronary artery disease and periodontitis reveals a novel shared risk locus. Sci Rep. 2018;8(1):13678.CrossRefPubMedPubMedCentral
39.
Xie R, Xiao M, Li L, Ma N, Liu M, Huang X, Liu Q, Zhang Y. Association between SII and hepatic steatosis and liver fibrosis: a population-based study. Front Immunol. 2022;13:925690.CrossRefPubMedPubMedCentral
40.
Xie R, Huang X, Liu Q, Liu M. Positive association between high-density lipoprotein cholesterol and bone mineral density in U.S. adults: the NHANES 2011–2018. J Orthop Surg Res. 2022;17(1):92.CrossRefPubMedPubMedCentral
41.
Xie R, Liu M. Relationship between non-alcoholic fatty liver disease and degree of hepatic steatosis and bone Mineral Density. Front Endocrinol (Lausanne). 2022;13:857110.CrossRefPubMed
Metadata
Title
Association of cardiovascular health and periodontitis: a population-based study
Authors
Haitao Qu
Shengnan Zhang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18001-2

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue

Research

A comparison between antibiotic utilisation in public and private community healthcare in Malaysia

Research

Maintaining the working state of firefighters by utilizing self-concept clarity as a resource

Research

Frequency of cigarette smoking and its associated factors among men in East Africa: a pooled prevalence analysis of national survey using multinomial regression

Retraction Note

Retraction Note: Children’s physical activity level and sedentary behaviour in Norwegian early childhood education and care: effects of a staff-led cluster-randomised controlled trial

Research

Prevalence, associated factors, and gene polymorphisms of obesity in Tibetan adults in Qinghai, China

Research

Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern