Association between periodontal disease and left ventricle mass in essential hypertension.
Dipartimento Malattie Cardiovascolari, Universita degli Studi
di Perugia and Ospedale R. Silvestrini, Perugia, Italy. fangeli@cardionet.it
Chronic periodontitis has been associated with an increased
risk for cardiovascular disease. Left ventricular mass is an
established independent predictor of cardiovascular disease.
In the present cross-sectional study, we tested the association
between periodontitis and left ventricular mass in subjects
with essential hypertension. One hundred four untreated subjects
with essential hypertension underwent clinical examinations,
including echocardiographic study, laboratory tests, and assessment
of periodontal status according to the community periodontal
index of treatment needs (CPITN). With increasing severity
of periodontitis, there was a progressive increase in left
ventricle mass. Mean values (g/height2.7) were 39.0 (+/-2.7)
in CPITN 0 (periodontal health), 40.2 (+/-6.4) in CPITN 1 (gingival
bleeding), 42.7 (+/-6.8) in CPITN 2 (calculus), 51.4 (+/-11.7)
in CPITN 3 (pockets 4 to 5 mm), and 76.7 (+/-11.3) in CPITN
4 (pockets > or =6 mm) (overall F 51.2; P<0.0001). Body
surface area (P=0.04), systolic (P<0.0001) and diastolic
(P<0.01) blood pressure, and left ventricular mass (P<0.0001)
were determinants of a composite of CPITN 3 and 4. In a multivariate
logistic analysis, left ventricular mass was the sole determinant
(P<0.0001) of CPITN stages 3 and 4. Our findings suggest
a direct association between severity of periodontitis and
left ventricular mass in subjects with essential hypertension.
Periodontal evaluation might contribute to refine cardiovascular
risk assessment in hypertensive subjects.
