Periodontal Disease and Cardiovascular Risk Factors: A Cross-Sectional Analysis of Inflammatory Pathway Associations

Background: Periodontal disease represents a significant global health burden and has been implicated as a potential contributor to the risk of cardiovascular disease (CVD). This study aimed to investigate the relationship between periodontal disease severity and established cardiovascular risk factors while exploring potential inflammatory mediators.

Methods: A cross-sectional study was conducted with 387 participants (aged 35-65) without established cardiovascular disease. Comprehensive periodontal examinations were performed, including measurements of pocket depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), and alveolar bone loss. Cardiovascular risk assessments included blood pressure, lipid profiles, glucose metabolism markers, high-sensitivity C-reactive protein (hs-CRP), and carotid intima-media thickness (cIMT). Linear and logistic regression models were used to analyze associations between periodontal parameters and cardiovascular risk factors, adjusting for relevant confounders.

Results: The severity of periodontal disease (defined by CAL ≥3 mm at ≥30% of sites) was significantly associated with elevated systolic blood pressure (β = 4.37 mmHg, 95% CI: 2.18-6.56, p < 0.001), higher hs-CRP levels (β = 0.76 mg/L, 95% CI: 0.41-1.11, p < 0.001), and increased cIMT (β = 0.038 mm, 95% CI: 0.012-0.064, p = 0.004) after adjusting for age, sex, smoking, body mass index, and socioeconomic factors. Path analysis demonstrated that approximately 27% of the association between periodontal disease and increased cIMT was mediated by elevated hs-CRP levels, suggesting potential involvement of an inflammatory pathway.

Conclusions: Our findings provide evidence for an independent association between periodontal disease severity and key cardiovascular risk factors, particularly systemic inflammation and subclinical atherosclerosis. These results support the hypothesis that periodontal disease may contribute to cardiovascular risk through inflammatory pathways, highlighting the importance of oral health in cardiovascular risk assessment and management.