Periodontitis and arterial stiffness: a systematic review and meta‐analysis
Abstract
Introduction and Aims: Patients with periodontitis have a higher risk of cardiovascular diseases, although a causal relationship between these conditions remains unclear. Arterial stiffness is considered a marker of arteriosclerosis and a risk factor for cardiovascular diseases. A systematic review of the literature on clinical studies using pulse wave velocity (PWV) to assess arterial stiffness in patients with periodontitis was carried out to answer the following questions: (i) Do patients with periodontitis have impaired arterial stiffness compared to non‐periodontal diseased subjects? (ii) Is periodontal treatment effective as a means to improve arterial stiffness in patients with periodontitis? Literature Review: Literature search was done on different databases up to September 2014. All clinical studies (excluding case reports) using PWV in patients with periodontitis were retrieved for a full‐text evaluation. A total of 10 studies were included. Patients with periodontitis have increased arterial stiffness compared to controls (PWV mean difference 0.85 m/s; 95% confidence interval: 0.53–1.16; p<0.00001). The only two interventional studies showed contradictory results on the effects of periodontal treatment on PWV. Conclusion: Patients with periodontitis appear to have higher values of PWV compared to controls. The effect of periodontal treatment on arterial stiffness remains unclear.
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Individuals with periodontitis have a higher prevalence of subclinical CVD, characterized by significant arterial stiffness and endothelial dysfunction.
“Additionally, there is evidence from various studies that individuals with periodontitis have a higher prevalence of subclinical CVD, which is characterized by significant arterial stiffness (assessed by pulse wave velocity [PWV]) [20] and endothelial dysfunction [21].”
From Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis (2024) · cites this paper as [20]
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042 · see citing works
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817 · see citing works
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · see citing works
Stang, A. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9491-z · Cited by 17,396 · see citing works
2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,638 · see citing works
Expert consensus document on arterial stiffness: methodological issues and clinical applications
Laurent, S., Cockcroft, J., Van Bortel, L., Boutouyrie, P., Giannattasio, C., Hayoz, D., Pannier, B., Vlachopoulos, C., Wilkinson, I., Struijker-Boudier, H., et al. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehl254 · Cited by 6,077 · see citing works
Self-citationDevelopment of a Classification System for Periodontal Diseases and Conditions
Armitage, G. C. (1999) · Annals of Periodontology · doi:10.1902/annals.1999.4.1.1 · Cited by 5,110 · see citing works
Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness
Vlachopoulos, C., Aznaouridis, K., & Stefanadis, C. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.10.061 · Cited by 4,165 · see citing works
The Reference Values for Arterial Stiffness' Collaboration (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq165 · Cited by 2,085 · see citing works
Long-Term Follow-Up of Patients With Mild Coronary Artery Disease and Endothelial Dysfunction
Suwaidi, J. M. S. A., Hamasaki, S., Higano, S. T., Nishimura, R. A., Holmes, D. R., & Lerman, A. (2000) · Circulation · doi:10.1161/01.cir.101.9.948 · Cited by 2,044 · see citing works
Aortic Pulse Wave Velocity Improves Cardiovascular Event Prediction
Ben-Shlomo, Y., Spears, M., Boustred, C., May, M., Anderson, S. G., Benjamin, E. J., Boutouyrie, P., Cameron, J., Chen, C.-H., Cruickshank, J. K., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.09.063 · Cited by 1,835 · see citing works
Self-citationThe clinical implications of endothelial dysfunction
Widlansky, M. E., Gokce, N., Keaney, J. F., & Vita, J. A. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)00994-x · Cited by 1,749 · cited 1× · see citing works
“(Widlansky et al., 2003, Suwaidi et al., 2000, Quyyumi, 2003, Heitzer et al., 2005) However, IMT has been recently challenged for its predictive value(Bots et al., 2014) and endothelial function is difficult to test in routine practice.”
A new system for grading recommendations in evidence based guidelines
Harbour, R., & Miller, J. (2001) · BMJ · doi:10.1136/bmj.323.7308.334 · Cited by 1,637 · see citing works
Treatment of periodontitis and endothelial function
Tonetti, M. S., D'Aiuto, F., Nibali, L., Donald, A., Storry, C., Parkar, M., Suvan, J., Hingorani, A. D., Vallance, P., & Deanfield, J. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa063186 · Cited by 1,326 · see citing works
Lockhart, P. B., Bolger, A. F., Papapanou, P. N., Osinbowale, O., Trevisan, M., Levison, M. E., Taubert, K. A., Newburger, J. W., Gornik, H. L., Gewitz, M. H., et al. (2012) · Circulation · doi:10.1161/cir.0b013e31825719f3 · Cited by 1,038 · see citing works
Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-analysis
Humphrey, L. L., Fu, R. F., Buckley, D., Freeman, M., & Helfand, M. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0787-6 · Cited by 723 · see citing works
Cecelja, M., & Chowienczyk, P. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.137653 · Cited by 664 · see citing works
Chronic Infections and the Risk of Carotid Atherosclerosis
Kiechl, S. J., Egger, G., Mayr, M., Wiedermann, C. J., Bonora, E., Oberhollenzer, F., Muggeo, M., Xu, Q., Wick, G., Poewe, W. H., et al. (2001) · Circulation · doi:10.1161/01.cir.103.8.1064 · Cited by 508 · see citing works
Tonetti, M. S., Van Dyke, T. E., & working group 1 of the joint EFP/AAP workshop (2013) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12089 · Cited by 395 · see citing works
Campbell, L. A., & Rosenfeld, M. E. (2011) · Thrombosis and Haemostasis · doi:10.1160/th11-06-0392 · Cited by 363 · see citing works
Non-Invasive Vascular Function Tests:
Tomiyama, H., & Yamashina, A. (2009) · Circulation Journal · doi:10.1253/circj.cj-09-0534 · Cited by 298 · see citing works
Friedewald, V. E., Kornman, K. S., Beck, J. D., Genco, R. J., Goldfine, A. B., Libby, P., Offenbacher, S., Ridker, P. M., Dyke, T. E. V., & Roberts, W. C. (2009) · Journal of Periodontology · doi:10.1902/jop.2009.097001 · Cited by 266 · see citing works
Shokawa, T., Imazu, M., Yamamoto, H., Toyofuku, M., Tasaki, N., Okimoto, T., Yamane, K., & Kohno, N. (2005) · Circulation Journal · doi:10.1253/circj.69.259 · Cited by 258 · see citing works
Periodontal treatment improves endothelial dysfunction in patients with severe periodontitis
Seinost, G., Wimmer, G., Skerget, M., Thaller, E., Brodmann, M., Gasser, R. N. A., Bratschko, R. O., & Pilger, E. (2005) · American Heart Journal · doi:10.1016/j.ahj.2004.09.059 · Cited by 253 · see citing works
Periodontal Infections and Coronary Heart Disease
Spahr, A., Klein, E., Khuseyinova, N., Boeckh, C., Muche, R., Kunze, M., Rothenbacher, D., Pezeshki, G., Hoffmeister, A., & Köenig, W. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.5.554 · Cited by 250 · see citing works
Detection of Periodontal Bacteria in Atheromatous Plaque by Nested Polymerase Chain Reaction
Figuero, E., Sánchez, M. C., Cuesta, S., Tejerina, J. M., del Castro-Madrazo, J. A., Gutiérrez, J. M., Herrera, D., & Sanz, M. (2011) · Journal of Periodontology · doi:10.1902/jop.2011.100719 · Cited by 214 · see citing works
The effects of periodontal therapy on vascular endothelial function: A pilot trial
Elter, J. R., Hinderliter, A. L., Offenbacher, S., Beck, J. D., Caughey, M. C., Brodala, N., & Madianos, P. (2005) · American Heart Journal · doi:10.1016/j.ahj.2005.10.002 · Cited by 193 · see citing works
Periodontal diseases and health: Consensus Report of the Sixth European Workshop on Periodontology
Kinane, D. F., Bouchard, P., & on behalf of group E of the European Workshop on Periodontology (2008) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2008.01278.x · Cited by 192 · see citing works
Self-citationPrognostic value of endothelial function
Quyyumi, A. A. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00430-2 · Cited by 182 · see citing works
Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases
Schenkein, H. A., & Loos, B. G. (2013) · Journal of Periodontology · doi:10.1902/jop.2013.134006 · Cited by 175 · see citing works
Orlandi, M., Suvan, J., Petrie, A., Donos, N., Masi, S., Hingorani, A., Deanfield, J., & D’Aiuto, F. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.06.002 · Cited by 164 · cited 1× · see citing works
“(Orlandi et al., 2014) Periodontal treatment was also found effective in improving endothelial function in patients with severe periodontitis.”
Systemic Endothelial Dysfunction as an Early Predictor of Adverse Outcome in Heart Failure
Heitzer, T. A., Baldus, S. E., Kodolitsch, Y. V., Rudolph, V., & Meinertz, T. (2005) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000166516.52477.81 · Cited by 157 · see citing works
Pharmacological Modulation of Arterial Stiffness
Boutouyrie, P., Lacolley, P. J., Briet, M. B., Regnault, V., Stanton, A. V., Laurent, S., & Mahmud, A. (2011) · Drugs · doi:10.2165/11593790-000000000-00000 · Cited by 147 · see citing works
Self-citationDemmer, R. T., Trinquart, L., Zuk, A. M., Fu, B. C., Blomkvist, J., Michalowicz, B. S., Ravaud, P., & Desvarieux, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0077441 · Cited by 133 · see citing works
Vidal, F., Cordovil, I., Figueredo, C. M. S., & Fischer, R. G. (2013) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12110 · Cited by 118 · see citing works
脈波伝播速度は心血管死亡を予想する ハワイ-ロサンゼルス-広島研究からの所見
Shokawa, T., Imazu, M., Yamamoto, H., Toyofuku, M., Tasaki, N., Okimoto, T., Yamane, K., & KOHNO, N. (2005) · Circulation · Cited by 111 · see citing works
Noninvasive assessment of preclinical atherosclerosis
Lane, H. A., Smith, J. C., & Davies, J. S. (2006) · Vascular Health and Risk Management · doi:10.2147/vhrm.2006.2.1.19 · Cited by 104 · see citing works
Aortic stiffness: pathophysiology, clinical implications, and approach to treatment
Sethi, S., Rivera, O., OLIVEROS, R. A., & CHILTON, R. J. (2014) · Integrated Blood Pressure Control · doi:10.2147/ibpc.s59535 · Cited by 94 · see citing works
Bots, M. L., Groenewegen, K. A., Anderson, T. J., Britton, A. R., Dekker, J. M., Engström, G., Evans, G., Graaf, J. D., Grobbee, D. E., Hedblad, B., et al. (2014) · Hypertension · doi:10.1161/hypertensionaha.113.02683 · Cited by 84 · see citing works
Holtfreter, B., Empen, K., Gläser, S., Lorbeer, R., Völzke, H., Ewert, R., Kocher, T., & Dörr, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0084603 · Cited by 79 · see citing works
Effect of Periodontal Therapy on Arterial Structure and Function Among Aboriginal Australians
Kapellas, K., Maple-Brown, L. J., Jamieson, L., Do, L., O’Dea, K., Brown, A. D. H., Cai, T. Y., Anstey, N. M., SULLIVAN, D. R., Wang, H., et al. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.03359 · Cited by 64 · see citing works
Franek, E., Klamczyńska, E., Ganowicz, E., Błach, A., Budlewski, T., & Górska, R. (2008) · American Journal of Hypertension · doi:10.1038/ajh.2008.330 · Cited by 59 · see citing works
Vieira, C. L. Z., Cury, P. R., Miname, M. H., Martinez, L. R. C., Bortolotto, L. A., Giuliano, I. D. C. B., Santos, R. D., & Caramelli, B. (2010) · Journal of Periodontology · doi:10.1902/jop.2010.100496 · Cited by 34 · see citing works
Hanaoka, Y., Soejima, H., Yasuda, O., Nakayama, H., Nagata, M., Matsuo, K., Shinohara, M., Izumi, Y., & Ogawa, H. (2013) · Hypertension Research · doi:10.1038/hr.2013.46 · Cited by 33 · see citing works
Shanker, J., Setty, P., Arvind, P., Nair, J., Bhasker, D., Balakrishna, G., & Kakkar, V. V. (2013) · Thrombosis Research · doi:10.1016/j.thromres.2013.04.023 · Cited by 30 · see citing works
Jockel‐Schneider, Y., Harks, I., Haubitz, I., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0103449 · Cited by 30 · see citing works
Franek, E., Januszkiewicz-Caulier, J., Błach, A., Napora, M., Jedynasty, K., Budlewski, T., Gozdowskı, D., & Górska, R. (2012) · PubMed · Cited by 26 · see citing works
Kapellas, K., Jamieson, L., Do, L., Bartold, P. M., Wang, H., Maple-Brown, L. J., SULLIVAN, D. R., O’Dea, K., Brown, A. D. H., Celermajer, D. S., et al. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.02.015 · Cited by 26 · see citing works
Miyaki, K., Masaki, K., Naito, M., Naito, T., Hoshi, K., Hara, A., Tohyama, S., & Nakayama, T. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-131 · Cited by 23 · see citing works
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“Additionally, there is evidence from various studies that individuals with periodontitis have a higher prevalence of subclinical CVD, which is characterized by significant arterial stiffness (assessed by pulse wave velocity [PWV]) [20] and endothelial dysfunction [21].”
Background
- Authors
- Schmitt, A., Carra, M. C., Boutouyrie, P., & Bouchard, P.
- Affiliations
- Hôpital Rothschild (FR)
- Inserm (FR)
- Corresponding author
- Boutouyrie, Pierre
- Bouchard, Philippe
- Venue
- Journal of Clinical Periodontology
- Publisher
- Wiley
- Published
- 2015-11
- Volume
- 42
- Issue
- 11
- Pages
- 977-987
- ISSN
- 0303-6979 (ISSN-L)
- 1600-051X
- OpenAlex
- W2140413377
- Cited by
- 65
- References
- 50
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 12 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 15 · 2019: 6 · 2018: 6 · 2017: 4 · 2016: 4
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal Of Clinical Periodontology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Keywords
- periodontitis, arterial stiffness, pulse wave velocity, cardiovascular risk, periodontal treatment, arteriosclerosis, cardiovascular disease
- MeSH terms
- Cardiovascular Diseases, Humans, Periodontitis, Risk Factors, Vascular Stiffness, Pulse Wave Analysis
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