Early Carotid Atherosclerosis in Subjects With Periodontal Diseases

Background and Purpose— There is growing experimental evidence implicating chronic inflammation/infection as an atherosclerotic risk factor. In this study, the involvement of periodontal disease in the development of early atherosclerotic vascular lesions has been evaluated. Methods— In randomly chosen 82 patients with periodontal disease and 31 periodontally healthy individuals subjected to a clinical oral examination in 1985, atherosclerotic risk factor analysis and carotid ultrasonography was performed during reexamination 16 years later. Common carotid artery intima-media thickness (IMT) and lumen diameter were measured and intima-media area (cIMA) was calculated. The relationship between IMT and cIMA as dependent variables and periodontal disease, age, gender, body mass index, heredity for atherosclerosis, diabetes mellitus, hypertension, plasma cholesterol, smoking, and education as independent variables was evaluated in a multiple logistic regression model. Results— The mean values of IMT and cIMA were significantly higher in patients with periodontal disease than in controls, both at the right ( P <0.01 and P <0.001, respectively) and left side ( P <0.001 for both variables). When the means of the bilateral measurements of these 2 ultrasonographic variables were tested, multiple logistic regression analysis identified periodontal disease as a principal independent predictor of the common carotid artery cIMA (odds ratio [OR], 5.20; P =0.003) and IMT (OR, 4.64; P =0.004). Conclusions— The present results indicate that periodontal disease is associated with the development of early atherosclerotic carotid lesions.