What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Severe periodontitis (n=158). Intervention: Severe periodontitis vs. Periodontally healthy controls. Primary outcome: Pulse wave velocity (PWV) (p=0.00004).

August 1, 2014Open Access

Arterial Stiffness and Pulse Wave Reflection Are Increased in Patients Suffering from Severe Periodontitis

YJYvonne Jockel‐SchneiderUniversity of Würzburg IHInga HarksUniversity Hospital Münster IHImme HaubitzUniversity of Würzburg

Key Result

Severe chronic or aggressive periodontitis was associated with significantly increased arterial stiffness, demonstrated by a higher pulse wave velocity (9.1 vs 7.7 m/s, p=0.00004) compared to healthy controls.

Study Design

Type

Cross-Sectional (n=158)

Blinding

Single-blind

Multicenter

Structured PICO

Does severe periodontitis increase arterial stiffness and pulse wave reflection compared to periodontally healthy controls?

Population

158 adults aged 36 and older, comprising 92 with severe periodontitis and 66 periodontally healthy controls, evaluated for arterial stiffness and pulse wave reflection.

Comparator

Matched periodontally healthy controls

Outcome

Vascular health evaluated by pulse wave velocity (PWV), augmentation index (AIx), and pulse pressure amplification (PPA) recorded using an oscillometric device (Arteriograph)surrogate

Severe periodontitis is associated with significantly increased arterial stiffness and pulse wave reflection, suggesting a higher cardiovascular risk profile in these patients.

Main Result

Absolute Event Rate: 9.1% vs 7.7%

p-value: p=0.00004

Limitations

Cross-sectional design precludes establishing causal relationships between periodontal and cardiovascular disease
Mechanisms underlying the observed vascular changes cannot be determined from the present data

Abstract

AIM: This single blind cross-sectional study compared the vascular health of subjects suffering from severe chronic periodontitis, severe aggressive periodontitis and periodontal healthy controls by evaluating pulse wave velocity (PWV), augmentation index (AIx) and pulse pressure amplification (PPA). MATERIAL AND METHODS: In a total of 158 subjects, 92 suffering from severe periodontitis and 66 matched periodontal healthy controls, PWV, AIx, central and peripheral blood pressure were recorded using an oscillometric device (Arteriograph). RESULTS: Subjects suffering from severe chronic or aggressive periodontitis exhibited significantly higher PWV (p = 0.00004), higher AIx (p = 0.0049) and lower PPA (p = 0.028) than matched periodontal healthy controls. CONCLUSIONS: The results of this study confirm the association between periodontal inflammation and increased cardiovascular risk shown by impaired vascular health in case of severe periodontitis. As impaired vascular health is a common finding in patients suffering from severe periodontal disease a concomitant routine cardiovascular evaluation may be advised.

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