The association between periodontitis and cardiovascular risks in asymptomatic healthy patients

H. C.M. Donders*, E. O. Veth, A. W.J. van ‘t Hof, J. de Lange, B. G. Loos

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Periodontitis is a chronic multifactorial inflammatory disease of the supportive tissues of the teeth. Pathophysiological evidence suggests a possible common inflammatory background between periodontitis and cardiovascular diseases (CVD). Pathological and epidemiological associations between these two diseases have been presented, but are still debated. This study aimed to investigate the association between the inflammatory burden of periodontitis and the presence and extent of coronary calcification. Secondary aims were to study other cardiovascular parameters and cardiovascular risk predictors in relation to periodontitis and dental health. Methods: Healthy periodontitis or non-periodontitis patients 45–70 years of age were included in a prospective cross-sectional study. Full-mouth examinations were performed by a periodontist to determine their Periodontal Inflamed Surface Area (PISA) score and other dental parameters. To assess the cardiovascular conditions, Coronary Artery Calcium (CAC) scores, endothelial function assessments by the EndoPAT ™, and several physical and biochemical examinations were performed. Results: Seventy-one patients were included. Elevated CAC scores and endothelial dysfunction were not significantly related to PISA or dental health. PISA was significantly related to the Framingham and Reynolds CVD risk predictors, but were no longer significant after correction for confounders. The same applied to the significant relations between tooth loss, dental plaque and bleeding scores and the CVD risk predictors. Conclusions: Periodontitis is associated with increased CVD risk, but is not an independent risk factor. This link is still important to make to bridge the gap between dentistry and general medicine and to identify patients at risk for CVD in an earlier stage.

Original languageEnglish
Article number200110
Pages (from-to)1-7
Number of pages7
JournalInternational Journal of Cardiology: Cardiovascular Risk and Prevention
Early online date15 Oct 2021
Publication statusPublished - Dec 2021

Bibliographical note

Funding Information:
This work was supported by the I&W fund of the Isala Academy , Zwolle ( INNO1310 ).

Publisher Copyright:
© 2021 The Authors


  • Cardiovascular disease
  • Coronary artery calcium (CAC) score
  • CVD prevention
  • CVD risk Prediction
  • Dental health
  • Periodontitis


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