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Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey

Identifieur interne : 002E56 ( Ncbi/Merge ); précédent : 002E55; suivant : 002E57

Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey

Auteurs : Cesar De Oliveira ; Richard Watt ; Mark Hamer

Source :

RBID : PMC:2877809

Abstract

Objective To examine if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).

Design National population based survey.

Setting Scottish Health Survey, which draws a nationally representative sample of the general population living in households in Scotland.

Participants 11 869 men and women, mean age 50 (SD 11).

Main outcome measures Oral hygiene assessed from self reported frequency of toothbrushing. Surveys were linked prospectively to clinical hospital records, and Cox proportional hazards models were used to estimate the risk of cardiovascular disease events or death according to oral hygiene. The association between oral hygiene and inflammatory markers and coagulation was examined in a subsample of participants (n=4830) by using general linear models with adjustments.

Results There were a total of 555 cardiovascular disease events over an average of 8.1 (SD 3.4) years of follow-up, of which 170 were fatal. In about 74% (411) of cardiovascular disease events the principal diagnosis was coronary heart disease. Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7, 95% confidence interval 1.3 to 2.3; P<0.001) in a fully adjusted model. They also had increased concentrations of both C reactive protein (β 0.04, 0.01 to 0.08) and fibrinogen (0.08, −0.01 to 0.18).

Conclusions Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation, though the causal nature of the association is yet to be determined.


Url:
DOI: 10.1136/bmj.c2451
PubMed: 20508025
PubMed Central: 2877809

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PMC:2877809

Le document en format XML

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<name sortKey="Watt, Richard" sort="Watt, Richard" uniqKey="Watt R" first="Richard" last="Watt">Richard Watt</name>
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<bold>Objective</bold>
To examine if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).</p>
<p>
<bold>Design</bold>
National population based survey.</p>
<p>
<bold>Setting</bold>
Scottish Health Survey, which draws a nationally representative sample of the general population living in households in Scotland.</p>
<p>
<bold>Participants</bold>
11 869 men and women, mean age 50 (SD 11).</p>
<p>
<bold>Main outcome measures</bold>
Oral hygiene assessed from self reported frequency of toothbrushing. Surveys were linked prospectively to clinical hospital records, and Cox proportional hazards models were used to estimate the risk of cardiovascular disease events or death according to oral hygiene. The association between oral hygiene and inflammatory markers and coagulation was examined in a subsample of participants (n=4830) by using general linear models with adjustments.</p>
<p>
<bold>Results</bold>
There were a total of 555 cardiovascular disease events over an average of 8.1 (SD 3.4) years of follow-up, of which 170 were fatal. In about 74% (411) of cardiovascular disease events the principal diagnosis was coronary heart disease. Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7, 95% confidence interval 1.3 to 2.3; P<0.001) in a fully adjusted model. They also had increased concentrations of both C reactive protein (β 0.04, 0.01 to 0.08) and fibrinogen (0.08, −0.01 to 0.18).</p>
<p>
<bold>Conclusions</bold>
Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation, though the causal nature of the association is yet to be determined.</p>
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<subject>Health Policy</subject>
<subject>Immunology (Including Allergy)</subject>
<subject>Drugs: Cardiovascular System</subject>
<subject>Ischaemic Heart Disease</subject>
<subject>Inflammation</subject>
<subject>Dentistry and Oral Medicine</subject>
<subject>Health Service Research</subject>
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<article-title>Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey</article-title>
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<name>
<surname>de Oliveira</surname>
<given-names>Cesar</given-names>
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<role>research fellow in epidemiology and public health</role>
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<name>
<surname>Watt</surname>
<given-names>Richard</given-names>
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<role>professor and honorary consultant in dental public health</role>
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<contrib contrib-type="author">
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<surname>Hamer</surname>
<given-names>Mark</given-names>
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<role>senior research fellow in epidemiology and public health</role>
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<aff id="aff1">
<label>1</label>
Department of Epidemiology and Public Health, University College London, London WC1E 6BT</aff>
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<author-notes>
<corresp>Correspondence to: R Watt
<email>r.watt@ucl.ac.uk</email>
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<pub-date pub-type="collection">
<year>2010</year>
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<pub-date pub-type="epub">
<day>27</day>
<month>5</month>
<year>2010</year>
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<volume>340</volume>
<elocation-id>c2451</elocation-id>
<history>
<date date-type="accepted">
<day>12</day>
<month>4</month>
<year>2010</year>
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<permissions>
<copyright-statement>© de Oliveira et al 2010</copyright-statement>
<copyright-year>2010</copyright-year>
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<license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See:
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/">http://creativecommons.org/licenses/by-nc/2.0/</ext-link>
and
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.</license-p>
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<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="bmj.c2451_default.pdf"></self-uri>
<abstract>
<p>
<bold>Objective</bold>
To examine if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).</p>
<p>
<bold>Design</bold>
National population based survey.</p>
<p>
<bold>Setting</bold>
Scottish Health Survey, which draws a nationally representative sample of the general population living in households in Scotland.</p>
<p>
<bold>Participants</bold>
11 869 men and women, mean age 50 (SD 11).</p>
<p>
<bold>Main outcome measures</bold>
Oral hygiene assessed from self reported frequency of toothbrushing. Surveys were linked prospectively to clinical hospital records, and Cox proportional hazards models were used to estimate the risk of cardiovascular disease events or death according to oral hygiene. The association between oral hygiene and inflammatory markers and coagulation was examined in a subsample of participants (n=4830) by using general linear models with adjustments.</p>
<p>
<bold>Results</bold>
There were a total of 555 cardiovascular disease events over an average of 8.1 (SD 3.4) years of follow-up, of which 170 were fatal. In about 74% (411) of cardiovascular disease events the principal diagnosis was coronary heart disease. Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7, 95% confidence interval 1.3 to 2.3; P<0.001) in a fully adjusted model. They also had increased concentrations of both C reactive protein (β 0.04, 0.01 to 0.08) and fibrinogen (0.08, −0.01 to 0.18).</p>
<p>
<bold>Conclusions</bold>
Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation, though the causal nature of the association is yet to be determined.</p>
</abstract>
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<label>Web Extra</label>
<title>Extra material supplied by the author</title>
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<caption>
<p>Cox regression models for toothbrushing and cardiovascular disease events in participants who gave blood sample</p>
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<p>Click here for additional data file.</p>
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<name sortKey="Watt, Richard" sort="Watt, Richard" uniqKey="Watt R" first="Richard" last="Watt">Richard Watt</name>
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