Relationship between carotid intima-media thickness and periodontal disease in a Japanese urban population with and without hypertension: The Suita Study

J Clin Periodontol. 2023 Feb;50(2):265-275. doi: 10.1111/jcpe.13740. Epub 2022 Nov 20.

Abstract

Aim: To investigate the association between periodontal disease and atherosclerosis and to examine whether the association is modified by hypertension status.

Materials and methods: In this cross-sectional study, 1472 Japanese individuals aged 50-79 years who underwent a medical check-up, dental examination, and carotid ultrasonography were studied. Carotid atherosclerosis was expressed as the maximum and mean carotid intima-media thickness (max-IMT, mean-IMT) and the presence of stenosis (≥75%). Periodontal status was examined by the Community Periodontal Index (CPI, codes 0-4). The participants were divided into three groups according to the periodontal status (CPI0-2, CPI3, CPI4).

Results: A positive correlation was found between mean-IMT and periodontal disease after adjustment for cardiovascular risk factors in the entire cohort (mean-IMT in hypertensives: CPI0-2: 0.848 mm, CPI3: 0.857 mm, CPI4: 0.877 mm; normotensives: 0.782, 0.802, 0.826). In the entire cohort, the multivariable-adjusted odds ratio of stenosis based on mean-IMT significantly increased according to periodontal status in normotensives (odds ratio; CPI0-2: 1, CPI3: 1.39, CPI4: 2.53; p-value for trend = .004) but showed only marginal significant increase in hypertensives (1, 1.15, 1.55; p-value for trend = .063). No significant relationships were observed for max-IMT in all analyses.

Conclusion: We observed an association between periodontal disease and atherosclerosis in normotensive and hypertensive participants.

Keywords: atherosclerosis; carotid intima-media thickness; cross-sectional study; hypertension; periodontal disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis* / complications
  • Carotid Arteries
  • Carotid Artery Diseases* / complications
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery Diseases* / epidemiology
  • Carotid Intima-Media Thickness
  • Constriction, Pathologic / complications
  • Cross-Sectional Studies
  • East Asian People
  • Humans
  • Hypertension* / complications
  • Hypertension* / epidemiology
  • Periodontal Diseases* / complications
  • Periodontal Diseases* / epidemiology
  • Risk Factors
  • Urban Population