Nav: Home

Poor oral health increases stroke risk, UB study finds

October 24, 2000

BUFFALO, N.Y. -- People with severe gum disease are at twice the risk of suffering a stroke than those with good oral health, University at Buffalo researchers have shown in the first national, population-based cohort study of periodontal disease and cerebrovascular disease. The increased risk was found only for stroke caused by blocked arteries, the most common type of stroke. There was no relationship between oral-health status and stroke caused by hemorrhage inside the brain.

Results of the study appear in the October issue of Archives of Internal Medicine. "This is the first major study to look at this question," said lead author Tiejian Wu, M.D., Ph.D., research assistant professor in the UB School of Medicine and Biomedical Sciences' Department of Social and Preventive Medicine.

"There have been a few other very limited studies, but the number of subjects was small and was drawn from restricted populations. This study also looked at subgroups -- men, women, blacks and non-blacks. Periodontal disease was associated with an increased risk for cerebrovascular disease in all groups." The relationship between gum disease and stroke was even stronger than the apparent link between gum disease and heart disease, he noted.

Recent studies, including several conducted at UB, have found that infection appears to be associated with increases in risk of heart disease, and periodontal disease is one of the most common human infections. However, little is known about the relationship between periodontal disease and cerebrovascular disease.

Wu said periodontal disease is thought to increase the risk of stroke in much the same way it increases the risk of heart attack.

"Bacteria, endotoxins and other bacterial products from gum pockets enter the circulation and may promote an inflammatory response, causing cells to proliferate in the blood vessels and the liver to increase production of clotting factors. Bacteria also may attack the vessel lining and damage endothelial cells," he explained.

"Further, several periodontal pathogens can induce platelet aggregation and may promote plaque formation that can cause blockages and clotting," he said. An earlier study conducted by UB researchers found periodontal bacteria in samples of carotid arterial plaque removed during surgery. The cohort for this study comprised 9,962 adults between the ages of 25 and 75 who took part in the first National Health and Nutrition Examination Survey (NHANES I), conducted from 1972-74, and its follow-up survey, which was completed in 1992.

The participants' oral health status, assessed as part of the NHANES survey, was placed in one of four categories: no periodontal disease, gingivitis, periodontitis or toothless. Gingivitis is an inflammation of the gums and is considered a relatively mild form of periodontal disease. Periodontitis is a severe infection involving the gums, membranes at the base of the teeth and the supporting bone and is the major cause of tooth loss in adults.

Wu and colleagues compiled information on the occurrence of stroke among participants by checking hospital records and death certificates in the follow-up survey. They assessed the risk of cerebrovascular events as a whole and of non-hemorrhagic and hemorrhagic stroke.

Results showed that periodontitis was a significant and independent risk factor for any cerebrovascular event and was associated with a two-fold increase in risk for non-hemorrhagic stroke. The study found no association between periodontal disease and hemorrhagic stroke.

"While more studies are needed for a conclusive statement about the cause-and-effect association, the consistency of the findings in different gender and racial groups and the strength of the association between two chronic conditions prevalent in the adult population may have important implications for individual and public health," Wu said.
-end-
Also participating in this study were Maurizio Trevisan, M.D., professor and chair of the UB Department of Social and Preventive Medicine and departmental faculty members Christopher Sempos, Ph.D., associate professor; Joan P. Dorn, Ph.D., assistant professor, and Karen L. Falkner, Ph.D., research assistant professor; and Robert J. Genco, D.D.S., Ph.D., professor and chair of the UB Department of Oral Biology, UB School of Dental Medicine.

The study was supported by grants from the National Institutes of Health and by a Buswell Fellowship from the UB medical school.

University at Buffalo

Related Heart Disease Articles:

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.
New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.
Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.
Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.
Women once considered low risk for heart disease show evidence of previous heart attack scars
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart attacks in men.
More Heart Disease News and Heart Disease Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...