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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-analysis</title>
<author><name sortKey="Humphrey, Linda L" sort="Humphrey, Linda L" uniqKey="Humphrey L" first="Linda L." last="Humphrey">Linda L. Humphrey</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff2">Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff3">Department of Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff4">Public Health and Preventive Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff7">Oregon Health & Science University, Hospital and Specialty Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff8">Oregon Health & Science University, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fu, Rongwei" sort="Fu, Rongwei" uniqKey="Fu R" first="Rongwei" last="Fu">Rongwei Fu</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff4">Public Health and Preventive Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff5">Emergency Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Buckley, David I" sort="Buckley, David I" uniqKey="Buckley D" first="David I." last="Buckley">David I. Buckley</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff2">Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff6">Family Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Freeman, Michele" sort="Freeman, Michele" uniqKey="Freeman M" first="Michele" last="Freeman">Michele Freeman</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Helfand, Mark" sort="Helfand, Mark" uniqKey="Helfand M" first="Mark" last="Helfand">Mark Helfand</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff2">Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff3">Department of Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff7">Oregon Health & Science University, Hospital and Specialty Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">18807098</idno>
<idno type="pmc">2596495</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2596495</idno>
<idno type="RBID">PMC:2596495</idno>
<idno type="doi">10.1007/s11606-008-0787-6</idno>
<date when="2008">2008</date>
<idno type="wicri:Area/Pmc/Corpus">001907</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001907</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-analysis</title>
<author><name sortKey="Humphrey, Linda L" sort="Humphrey, Linda L" uniqKey="Humphrey L" first="Linda L." last="Humphrey">Linda L. Humphrey</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff2">Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff3">Department of Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff4">Public Health and Preventive Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff7">Oregon Health & Science University, Hospital and Specialty Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff8">Oregon Health & Science University, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fu, Rongwei" sort="Fu, Rongwei" uniqKey="Fu R" first="Rongwei" last="Fu">Rongwei Fu</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff4">Public Health and Preventive Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff5">Emergency Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Buckley, David I" sort="Buckley, David I" uniqKey="Buckley D" first="David I." last="Buckley">David I. Buckley</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff2">Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff6">Family Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Freeman, Michele" sort="Freeman, Michele" uniqKey="Freeman M" first="Michele" last="Freeman">Michele Freeman</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Helfand, Mark" sort="Helfand, Mark" uniqKey="Helfand M" first="Mark" last="Helfand">Mark Helfand</name>
<affiliation><nlm:aff id="Aff1">Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff2">Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff3">Department of Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="Aff7">Oregon Health & Science University, Hospital and Specialty Medicine, Veterans Affairs Medical Center, Portland, OR USA</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of General Internal Medicine</title>
<idno type="ISSN">0884-8734</idno>
<idno type="eISSN">1525-1497</idno>
<imprint><date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND</title>
<p>Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD).</p>
</sec>
<sec><title>OBJECTIVE</title>
<p>To aid the United States Preventive Services Task Force (USPSTF) in evaluating whether periodontal disease is an independent novel risk factor for incident CHD.</p>
</sec>
<sec><title>METHODS</title>
<p>Studies were identified by searching Medline (1966 through March 2008) and reviewing prior systematic reviews, reference lists, and consulting experts. Prospective cohort studies that assessed periodontal disease, Framingham risk factors, and coronary heart disease incidence in the general adult population without known CHD were reviewed and quality rated using criteria developed by the USPSTF. Meta-analysis of good and fair quality studies was conducted to determine summary estimates of the risk of CHD events associated with various categories of periodontal disease.</p>
</sec>
<sec><title>RESULTS</title>
<p>We identified seven articles of good or fair quality from seven cohorts. Several studies found periodontal disease to be independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis, and bone loss) ranged from 1.24 (95% CI 1.01–1.51) to 1.34 (95% CI 1.10–1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality, and method of periodontal disease assessment.</p>
</sec>
<sec><title>CONCLUSION</title>
<p>Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Gen Intern Med</journal-id>
<journal-title>Journal of General Internal Medicine</journal-title>
<issn pub-type="ppub">0884-8734</issn>
<issn pub-type="epub">1525-1497</issn>
<publisher><publisher-name>Springer-Verlag</publisher-name>
<publisher-loc>New York</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">18807098</article-id>
<article-id pub-id-type="pmc">2596495</article-id>
<article-id pub-id-type="publisher-id">787</article-id>
<article-id pub-id-type="doi">10.1007/s11606-008-0787-6</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Clinical Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-analysis</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name name-style="western"><surname>Humphrey</surname>
<given-names>Linda L.</given-names>
</name>
<degrees>MD, MPH</degrees>
<address><email>Humphrey@ohsu.edu</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff2">2</xref>
<xref ref-type="aff" rid="Aff3">3</xref>
<xref ref-type="aff" rid="Aff4">4</xref>
<xref ref-type="aff" rid="Aff7">7</xref>
<xref ref-type="aff" rid="Aff8">8</xref>
</contrib>
<contrib contrib-type="author"><name name-style="western"><surname>Fu</surname>
<given-names>Rongwei</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff4">4</xref>
<xref ref-type="aff" rid="Aff5">5</xref>
</contrib>
<contrib contrib-type="author"><name name-style="western"><surname>Buckley</surname>
<given-names>David I.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff2">2</xref>
<xref ref-type="aff" rid="Aff6">6</xref>
</contrib>
<contrib contrib-type="author"><name name-style="western"><surname>Freeman</surname>
<given-names>Michele</given-names>
</name>
<degrees>MPH</degrees>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name name-style="western"><surname>Helfand</surname>
<given-names>Mark</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff2">2</xref>
<xref ref-type="aff" rid="Aff3">3</xref>
<xref ref-type="aff" rid="Aff7">7</xref>
</contrib>
<aff id="Aff1"><label>1</label>
Oregon Evidence-based Practice Center, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff2"><label>2</label>
Department of Medical Informatics and Clinical Epidemiology, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff3"><label>3</label>
Department of Medicine, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff4"><label>4</label>
Public Health and Preventive Medicine, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff5"><label>5</label>
Emergency Medicine, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff6"><label>6</label>
Family Medicine, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff7"><label>7</label>
Oregon Health & Science University, Hospital and Specialty Medicine, Veterans Affairs Medical Center, Portland, OR USA</aff>
<aff id="Aff8"><label>8</label>
Oregon Health & Science University, Portland, OR USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>20</day>
<month>9</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub"><month>12</month>
<year>2008</year>
</pub-date>
<volume>23</volume>
<issue>12</issue>
<fpage>2079</fpage>
<lpage>2086</lpage>
<history><date date-type="received"><day>16</day>
<month>1</month>
<year>2008</year>
</date>
<date date-type="rev-recd"><day>18</day>
<month>6</month>
<year>2008</year>
</date>
<date date-type="accepted"><day>28</day>
<month>8</month>
<year>2008</year>
</date>
</history>
<permissions><copyright-statement>© Society of General Internal Medicine 2008</copyright-statement>
</permissions>
<abstract><sec><title>BACKGROUND</title>
<p>Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD).</p>
</sec>
<sec><title>OBJECTIVE</title>
<p>To aid the United States Preventive Services Task Force (USPSTF) in evaluating whether periodontal disease is an independent novel risk factor for incident CHD.</p>
</sec>
<sec><title>METHODS</title>
<p>Studies were identified by searching Medline (1966 through March 2008) and reviewing prior systematic reviews, reference lists, and consulting experts. Prospective cohort studies that assessed periodontal disease, Framingham risk factors, and coronary heart disease incidence in the general adult population without known CHD were reviewed and quality rated using criteria developed by the USPSTF. Meta-analysis of good and fair quality studies was conducted to determine summary estimates of the risk of CHD events associated with various categories of periodontal disease.</p>
</sec>
<sec><title>RESULTS</title>
<p>We identified seven articles of good or fair quality from seven cohorts. Several studies found periodontal disease to be independently associated with increased risk of CHD. Summary relative risk estimates for different categories of periodontal disease (including periodontitis, tooth loss, gingivitis, and bone loss) ranged from 1.24 (95% CI 1.01–1.51) to 1.34 (95% CI 1.10–1.63). Risk estimates were similar in subgroup analyses by gender, outcome, study quality, and method of periodontal disease assessment.</p>
</sec>
<sec><title>CONCLUSION</title>
<p>Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.</p>
</sec>
</abstract>
<custom-meta-wrap><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Society of General Internal Medicine 2008</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
</pmc>
</record>
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