Objectives. This study aimed to determine the association between some oral health status as a risk factor for cardiac diseases and other cardiovascular disease (CVD) risk factors in a sample of Iranian population in 2011. Methods. The study recruited 5900 inhabitants who aged 15–75 years old of Kerman city through a population based cluster sampling. Having collected informed consent, participants were interviewed for CVD risk factors. Some oral health indicators such as DMFT, Gingival Inflammation index, and Community Periodontal Index were assessed. The association between oral health indices and CVD risk factors was tested using multivariate regression models. Results. The mean age of participants was 33.5 years, and 45.1% were male. Moderate gingival inflammation was observed in 67.6% of participants. Presence of sub- or supragingival calculus was more common (90%) in participants. Older age (RR from 2.7 to 3.88), cigarette smoking (RR = 1.49), and high blood glucose (RR = 1.41) showed an increased risk for oral diseases after adjustment for different covariates including established CVD risk factors. Conclusion. The study results showed an increase in periodontal diseases in the presence of some CVD risk factors. Therefore there may be a bilateral but independent association for both conditions and common risk factor approach preventive program is highly recommended. 1. Introduction It is estimated that three-quarter of the global burden of cardiovascular disease (CVD) occurs in developing countries [1]. Sadly, it seems that in most of developing countries the mortality and morbidity due to CVD would have a sharp increase in the following decades because of the high prevalence of risk factors and also aging of their populations. Iran, a developing country with more than 70 million population, is also facing with the epidemic of CVD [2]. The prevalence of coronary artery disease is as high as 20% in its capital, Tehran [3]. Myocardial infarction is among the first top three causes of death [4], and based on the results of a dynamic model, it seems that around 53 myocardial infarction per million population occurs daily in Iran [5]. CVD has a complex etiology determined by numerous risk factors that are strongly affected by genetic, socio-economic, and environmental variables [6]. In between, the role of inflammation in CVD has been investigated in many contexts in recent years and increasing body of evidence is being gathered in favor of the role of inflammation in the pathogenesis of CVD [7]. In this regards mouth pathogens and periodontal disease
References
[1]
C. J. L. Murray and A. D. Lopez, “Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study,” The Lancet, vol. 349, no. 9064, pp. 1498–1504, 1997.
[2]
M. Naghavi, Features of Death in 18 Province of Iran in 2000, Tandis Publications, Tehran, Iran, 2002.
[3]
F. Hadaegh, H. Harati, A. Ghanbarian, and F. Azizi, “Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study,” Eastern Mediterranean Health Journal, vol. 15, no. 1, pp. 157–166, 2009.
[4]
M. Naghavi and N. Jafari, Death Registration in 29 Provinces in Iran in 2005, The Ministry of Health and Medical Education, Tehran, Iran, 2007.
[5]
N. Talebizadeh, A. A. Haghdoost, and A. Mirzazadeh, “An epidemiological model on cardiovascular disease in Iran,” Payesh Journal, vol. 8, no. 2, pp. 163–170, 2009.
[6]
R. M. Semenciw, H. I. Morrison, Y. Mao, H. Johansen, J. W. Davies, and D. T. Wigle, “Major risk factors for cardiovascular disease mortality in adults: results from the Nutrition Canada survey cohort,” International Journal of Epidemiology, vol. 17, no. 2, pp. 317–324, 1988.
[7]
K. J. Mattila, V. V. Valtonen, M. S. Nieminen, and S. Asikainen, “Role of infection as a risk factor for atherosclerosis, myocardial infarction, and stroke,” Clinical Infectious Diseases, vol. 26, no. 3, pp. 719–734, 1998.
[8]
J. Danesh, J. G. Wheeler, G. M. Hirschfield et al., “C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease,” The New England Journal of Medicine, vol. 350, no. 14, pp. 1387–1397, 2004.
[9]
B. G. Loos, J. Craandijk, F. J. Hoek, P. M. E. Wertheim-van Dillen, and U. van der Velden, “Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients,” Journal of Periodontology, vol. 71, no. 10, pp. 1528–1534, 2000.
[10]
Community Periodontal Index in 35 to 44 Years Old Iranians, Oral Health Department of Ministry of Health and Medical Education of Iran, 2002.
[11]
J. H. Meurman, M. Sanz, and S.-J. Janket, “Oral health, atherosclerosis, and cardiovascular disease,” Critical Reviews in Oral Biology and Medicine, vol. 15, no. 6, pp. 403–413, 2004.
[12]
H.-C. Hung, W. Willett, A. Merchant, B. A. Rosner, A. Ascherio, and K. J. Joshipura, “Oral health and peripheral arterial disease,” Circulation, vol. 107, no. 8, pp. 1152–1157, 2003.
[13]
A. A. Bahekar, S. Singh, S. Saha, J. Molnar, and R. Arora, “The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis,” American Heart Journal, vol. 154, no. 5, pp. 830–837, 2007.
[14]
S. J. Frisbee, C. B. Chambers, J. C. Frisbee, A. G. Goodwill, and R. J. Crout, “Association between dental hygiene, cardiovascular disease risk factors and systemic inflammation in rural adults,” Journal of Dental Hygiene, vol. 84, no. 4, pp. 177–184, 2010.
[15]
H. Najafipour, A. Mirzazadeh, A. A. Haghdoost, et al., “Coronary artery disease risk factors in an urban and peri-urban setting, Kerman, Southeastern Iran (KERCADR study): methodology and preliminary report,” Iranian Journal of Public Health, vol. 41, no. 9, pp. 86–92, 2012.
[16]
“Dentition status and criteria for diagnosis and coding (Caries),” in WHO Oral Health Surveys—Basic Methods, pp. 39–44, WHO, Geneva, Switzerland, 1997.
[17]
J. Silness and H. Loe, “Periodontal disease in pregnancy. II—correlation between oral hygiene and periodontal condition,” Acta Odontologica Scandinavica, vol. 22, pp. 121–135, 1964.
[18]
T. Malek Mohammadi and A. Hajizamani, Indices for Measuring Health and Diseases in Dentistry, Kerman University of Medical Sciences, 1st edition, 2011.
[19]
V. Baelum, W.-M. Luan, X. Chen, and O. Fejerskov, “A 10-year study of the progression of destructive periodontal disease in adult and elderly Chinese,” Journal of Periodontology, vol. 68, no. 11, pp. 1033–1042, 1997.
[20]
J. D. Beck, T. Sharp, G. G. Koch, and S. Offenbacher, “A study of attachment loss patterns in survivor teeth at 18 months, 36 months and 5 years in community-dwelling older adults,” Journal of Periodontal Research, vol. 32, no. 6, pp. 497–505, 1997.
[21]
E. E. Machtei, E. Hausmann, R. Dunford et al., “Longitudinal study of predictive factors for periodontal disease and tooth loss,” Journal of Clinical Periodontology, vol. 26, no. 6, pp. 374–380, 1999.
[22]
H. Ogawa, A. Yoshihara, T. Hirotomi, Y. Ando, and H. Miyazaki, “Risk factors for periodontal disease progression among elderly people,” Journal of Clinical Periodontology, vol. 29, no. 7, pp. 592–597, 2002.
[23]
K. J. Mattila, “Dental infections as a risk factor for acute myocardial infarction,” European Heart Journal, vol. 14, supplement K, pp. 51–53, 1993.
[24]
A. Holmlund, G. Holm, and L. Lind, “Severity of periodontal disease and number of remaining teeth are related to the prevalence of Myocardial infarction and hypertension in a study based on 4,254 subjects,” Journal of Periodontology, vol. 77, no. 7, pp. 1173–1178, 2006.
[25]
C. de Oliveira, R. Watt, and M. Hamer, “Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey,” British Medical Journal, vol. 340, article c2451, 6 pages, 2010.
[26]
T. H. Howell, P. M. Ridker, U. A. Ajani, C. H. Hennekens, and W. G. Christen, “Periodontal disease and risk of subsequent cardiovascular disease in U.S. male physicians,” Journal of the American College of Cardiology, vol. 37, no. 2, pp. 445–450, 2001.
[27]
P. P. Hujoel, M. Drangsholt, C. Spiekerman, and T. A. DeRouen, “Periodontal disease and coronary heart disease risk,” Journal of the American Medical Association, vol. 284, no. 11, pp. 1406–1410, 2000.
[28]
P. P. Hujoel, M. Drangsholt, C. Spiekerman, and T. A. DeRouen, “Periodontitis-systemic disease associations in the presence of smoking—causal or coincidental?” Periodontology 2000, vol. 30, no. 1, pp. 51–60, 2002.
[29]
P. B. Lockhart, A. F. Bolger, P. N. Papapanou et al., “Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association,” Circulation, vol. 125, pp. 2520–2544, 2012.
