Periodontitis and incidence of cerebrovascular disease in men
Identifieur interne : 002976 ( Ncbi/Merge ); précédent : 002975; suivant : 002977Periodontitis and incidence of cerebrovascular disease in men
Auteurs : Monik Jimenez [États-Unis] ; Elizabeth A. Krall ; Raul I. Garcia ; Pantel S. Vokonas ; Thomas Dietrich [Royaume-Uni]Source :
- Annals of neurology [ 0364-5134 ] ; 2009.
Abstract
To identify associations between periodontitis and incidence of cerebrovascular disease.
We analyzed data of 1,137 dentate men in the VA Normative Aging and Dental Longitudinal Study who were followed with triennial medical/dental exams for up to 34 years (mean 24 years). We evaluated incidence of cerebrovascular events consistent with stroke or transient ischemic attack in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation). Cox proportional hazards models were fit controlling for age, baseline socio-economic status and time varying effects of established cardiovascular risk factors.
Eighty incident cases of cerebrovascular disease occurred from 27,506 person-years. Periodontal bone loss was significantly associated with an increased hazard rate of cerebrovascular disease (HR: 3.52, 95% CI: 1.59, 7.81 comparing highest to lowest bone loss category, p for trend <0.001). There was a stronger effect among men aged <65 yrs (HR: 5.81, 95% CI: 1.63, 20.7) as compared to men ≥65 yrs (HR: 2.39, 95% CI: 0.91, 6.25). Periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease in the combined or age stratified analyses.
These results support an association between history of periodontitis - but not current periodontal inflammation - and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, particularly among men younger than 65 years.
Url:
DOI: 10.1002/ana.21742
PubMed: 19847898
PubMed Central: 2783821
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<wicri:noCountry code="subfield">VA Boston Healthcare System</wicri:noCountry>
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<wicri:noCountry code="subfield">Boston University</wicri:noCountry>
</affiliation>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To identify associations between periodontitis and incidence of cerebrovascular disease.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We analyzed data of 1,137 dentate men in the VA Normative Aging and Dental Longitudinal Study who were followed with triennial medical/dental exams for up to 34 years (mean 24 years). We evaluated incidence of cerebrovascular events consistent with stroke or transient ischemic attack in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation). Cox proportional hazards models were fit controlling for age, baseline socio-economic status and time varying effects of established cardiovascular risk factors.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Eighty incident cases of cerebrovascular disease occurred from 27,506 person-years. Periodontal bone loss was significantly associated with an increased hazard rate of cerebrovascular disease (HR: 3.52, 95% CI: 1.59, 7.81 comparing highest to lowest bone loss category, p for trend <0.001). There was a stronger effect among men aged <65 yrs (HR: 5.81, 95% CI: 1.63, 20.7) as compared to men ≥65 yrs (HR: 2.39, 95% CI: 0.91, 6.25). Periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease in the combined or age stratified analyses.</p>
</sec>
<sec id="S4"><title>Interpretation</title>
<p id="P4">These results support an association between history of periodontitis - but not current periodontal inflammation - and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, particularly among men younger than 65 years.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7707449</journal-id>
<journal-id journal-id-type="pubmed-jr-id">656</journal-id>
<journal-id journal-id-type="nlm-ta">Ann Neurol</journal-id>
<journal-title>Annals of neurology</journal-title>
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<article-id pub-id-type="doi">10.1002/ana.21742</article-id>
<article-id pub-id-type="manuscript">NIHMS136015</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Periodontitis and incidence of cerebrovascular disease in men</article-title>
<subtitle>Periodontitis & cerebrovascular disease in men</subtitle>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Jimenez</surname>
<given-names>Monik</given-names>
</name>
<degrees>SM</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Krall</surname>
<given-names>Elizabeth A.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Garcia</surname>
<given-names>Raul I.</given-names>
</name>
<degrees>DMD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vokonas</surname>
<given-names>Pantel S.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dietrich</surname>
<given-names>Thomas</given-names>
</name>
<degrees>DMD</degrees>
<xref ref-type="aff" rid="A6">6</xref>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Dept. of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine</aff>
<aff id="A2"><label>2</label>
Dept. of Epidemiology, Harvard School of Public Health</aff>
<aff id="A3"><label>3</label>
Dept. of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, USA</aff>
<aff id="A4"><label>4</label>
VA Normative Aging Study, VA Boston Healthcare System</aff>
<aff id="A5"><label>5</label>
Dept. of Medicine, Boston University School of Medicine, Dept. of Epidemiology, Boston University</aff>
<aff id="A6"><label>6</label>
Dept. of Oral Surgery, The School of Dentistry, University of Birmingham, Birmingham, UK</aff>
<author-notes><corresp id="cor1"><bold>Corresponding Author:</bold>
Thomas Dietrich, Professor and Head of Oral Surgery, The School of Dentistry, University of Birmingham, St Chad's Queensway, Birmingham, B4 6NN, United Kingdom, Tel: +44-121-237-2825, Fax: +44-121-237-2827. Email: <email>t.dietrich@bham.ac.uk</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>4</day>
<month>8</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>10</month>
<year>2010</year>
</pub-date>
<volume>66</volume>
<issue>4</issue>
<fpage>505</fpage>
<lpage>512</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To identify associations between periodontitis and incidence of cerebrovascular disease.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We analyzed data of 1,137 dentate men in the VA Normative Aging and Dental Longitudinal Study who were followed with triennial medical/dental exams for up to 34 years (mean 24 years). We evaluated incidence of cerebrovascular events consistent with stroke or transient ischemic attack in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation). Cox proportional hazards models were fit controlling for age, baseline socio-economic status and time varying effects of established cardiovascular risk factors.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Eighty incident cases of cerebrovascular disease occurred from 27,506 person-years. Periodontal bone loss was significantly associated with an increased hazard rate of cerebrovascular disease (HR: 3.52, 95% CI: 1.59, 7.81 comparing highest to lowest bone loss category, p for trend <0.001). There was a stronger effect among men aged <65 yrs (HR: 5.81, 95% CI: 1.63, 20.7) as compared to men ≥65 yrs (HR: 2.39, 95% CI: 0.91, 6.25). Periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease in the combined or age stratified analyses.</p>
</sec>
<sec id="S4"><title>Interpretation</title>
<p id="P4">These results support an association between history of periodontitis - but not current periodontal inflammation - and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, particularly among men younger than 65 years.</p>
</sec>
</abstract>
<kwd-group><kwd>Epidemiology</kwd>
<kwd>Risk Factors for Stroke</kwd>
<kwd>Transient Ischemic Attacks</kwd>
<kwd>Periodontal Diseases</kwd>
</kwd-group>
<contract-num rid="DE1">R03 DE016357-02
||DE</contract-num>
<contract-sponsor id="DE1">National Institute of Dental and Craniofacial Research : NIDCR</contract-sponsor>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Massachusetts</li>
<li>Midlands de l'Ouest</li>
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<settlement><li>Birmingham</li>
<li>Boston</li>
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<orgName><li>Université de Birmingham</li>
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<tree><noCountry><name sortKey="Garcia, Raul I" sort="Garcia, Raul I" uniqKey="Garcia R" first="Raul I." last="Garcia">Raul I. Garcia</name>
<name sortKey="Krall, Elizabeth A" sort="Krall, Elizabeth A" uniqKey="Krall E" first="Elizabeth A." last="Krall">Elizabeth A. Krall</name>
<name sortKey="Vokonas, Pantel S" sort="Vokonas, Pantel S" uniqKey="Vokonas P" first="Pantel S." last="Vokonas">Pantel S. Vokonas</name>
</noCountry>
<country name="États-Unis"><region name="Massachusetts"><name sortKey="Jimenez, Monik" sort="Jimenez, Monik" uniqKey="Jimenez M" first="Monik" last="Jimenez">Monik Jimenez</name>
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</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Dietrich, Thomas" sort="Dietrich, Thomas" uniqKey="Dietrich T" first="Thomas" last="Dietrich">Thomas Dietrich</name>
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