Evidence of Association between Periodontitis and CVD

Acute and chronic systemic inflammation has been shown to have pro-atherogenic effects. C-reactive protein (CRP), a marker of systemic inflammation, has a high predictive value for future cardiovascular events.67,68,29 Reduction of CRP in patients with low serum cholesterol levels has demonstrated a significant reduction in myocardial infarction (MI) and stroke.70 Individuals with periodontal diseases demonstrate elevated systemic CRP levels compared to periodontally healthy subjects.71-74 The severity of periodontitis and quantity of periodontal pathogens have been shown to be positivity correlated with CRP levels.75,77 The presence of Porphryomonas gingivalis (P.g.) in periodontal pockets has been demonstrated to induce pronounced CRP increases.76,77 Furthermore, periodontal pathogens have been identified in atheromas and may be associated with increased levels of platelet aggregation.78 While there is a biologic plausibility for a linkage between periodontal disease and CVD, epidemiologic and interventional studies have not established a conclusive causal relationship. Studies have suggested that periodontal disease may confer a moderate risk for atherosclerosis and its consequences.13-15