Your Mouth and Heart Disease

ScienceDaily (Dec. 7, 2008) — Individuals 

reporting a history of periodontal disease 

were more likely to have increased levels of 

inflammation, a risk factor for heart 

disease, compared to those who reported no 

history of periodontal disease, according to 

an American Journal of Cardiology report 

available online. 

Led by investigators from Columbia University 

Medical Center and NewYork-Presbyterian 

Hospital, the findings suggest persons with 

increased levels of inflammatory markers 

associated with a higher risk of 

cardiovascular disease might be identified by 

asking about oral health history. This group 

might not be detected by traditional 

cardiovascular risk screening. 

Inflammation has been associated with 

cardiovascular disease and has been suggested 

to be a potential link between periodontal 

disease and cardiovascular disease. To 

examine whether oral health history and 

inflammatory markers associated with 

cardiovascular disease were linked, the 

investigators followed participants in the 

National Heart, Lung and Blood Institute 

(NHLBI) Family Intervention Trial for Heart 

Health (F.I.T. Heart), an ongoing national 

trial led by principal investigator Lori 

Mosca, M.D., M.P.H., Ph.D., professor of 

medicine at Columbia University College of 

Physicians and Surgeons and director of 

preventive cardiology at NewYork-Presbyterian 

Hospital/Columbia University Medical Center. 

The NHLBI Family Intervention Trial for Heart 

Health aims to study family members of 

patients hospitalized with heart disease 

because they may be at increased risk 

themselves due to shared genetic and/or 

lifestyle factors. Dr. Mosca and her research 

team recruited family members or co-habitants 

of patients hospitalized for such cardiac 

events as a heart attack or narrowed arteries 

that required bypass surgery or an 

angioplasty procedure. Previous research has 

shown that family members of cardiovascular 

disease patients may be at increased risk for 

the disease due to the genes and lifestyle 

habits they share. 

In this study, 421 individuals who were blood 

related to and/or living with a person 

recently hospitalized due to cardiovascular 

disease were screened for traditional 

cardiovascular risk factors (such as elevated 

blood pressure and abnormal cholesterol 

levels), inflammatory markers associated with 

disease risk (high-sensitivity c-reactive 

protein (hsCRP) and lipoprotein-associated 

phospholipase A2 (Lp-PLA2)). They were also 

asked standardized questions about their oral 

health status, including whether they had 

ever been diagnosed with periodontal (gum) 

disease, whether they had ever been treated 

for periodontal disease, whether they used 

partial or complete removable dentures, and 

the date of their last teeth cleaning. The 

oral health history was then correlated with 

standard markers of inflammation. 

Results found that among participants who did 

not have traditional cardiovascular disease 

risk factors (such as high blood pressure, 

high cholesterol, and overweight/obese 

status), almost one in four were found to 

have a personal history of periodontal 

disease and higher levels of Lp-PLA2, an 

inflammatory marker which has been found 

present in inflamed rupture prone plaque in 

heart arteries/valves. 

It is important to note that it is not 

possible to determine from this study that 

poor oral health causes cardiovascular 

disease risk or that any therapy based on 

oral health status would be effective in 

preventing cardiovascular disease. However, 

Dr. Mosca says, "Our finding is novel because 

it suggests the dentist and oral health exam 

may be the latest weapon in identifying 

persons at risk of cardiovascular disease, 

our nation's number one killer." 

"Many people don't realize how oral health is 

often a predictor of one's overall health," 

says co-author John T. Grbic, DMD, MS, MMSc, 

professor of clinical dental medicine at the 

Columbia University College of Dental 

Medicine. "Symptoms for many life-threatening 

illnesses, such as diabetes and heart 

disease, first appear in the mouth. For this 

reason, it's vitally important for people to 

have routine dental check-ups and have an 

ongoing dialogue with their dentist about 

their oral health. Patients may also benefit 

from seeing dentists affiliated with an 

academic medical center, where they are 

tapped into deep referral networks to 

appropriate clinicians."