Issue Highlights

There currently is great interest in understanding the role of certain chronic infections as risk factors for cardiovascular disease. In this regard, prior studies have suggested that chronic periodontal disease is associated with increased cardiovascular risk, although it remains possible that the confounding effects of smoking and other classical risk factors explain the association. In this issue of Circulation, Beck and colleagues investigated the relation between periodontal disease and prevalent coronary heart disease in 5002 participants in the fourth examination of the Atherosclerosis Risk in Communities Study. They observed that elevated serum IgG antibodies to several oral pathogens were associated with coronary heart disease, but findings on oral examination were not. Although further prospective studies of this question are needed, the present study suggests that the host response to oral infection may be more important for cardiovascular risk than the local extent of periodontal disease. See p 19.