A population-based cross-sectional study of the association between periodontitis and arterial stiffness among the older Japanese population

J Periodontal Res. 2021 Apr;56(2):423-431. doi: 10.1111/jre.12835. Epub 2020 Dec 28.


Objective: To investigate the potential association between periodontitis and arterial stiffness among the older Japanese population.

Background: The prevalence of periodontitis is increasing in Japanese older adults. Arterial stiffness increases the risks of cardiovascular events and death, morbidity, and dementia.

Methods: This secondary analysis of data from a cross-sectional study evaluated the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue that was estimated by a full-mouth periodontal examination. Severe periodontitis was defined per the parameters provided by the Centers for Disease Control/American Academy of Periodontology. The Cardio-Ankle Vascular Index (CAVI) was used for measuring the overall stiffness of the artery, and higher CAVI indicated increased arterial stiffness. An ordinal logistic regression model was used to evaluate the association between periodontitis and arterial stiffness.

Results: The analysis included 185 Japanese adults [35% men; age, mean (standard deviation) 80.2 (4.4) years]. The average PISA and the prevalence of severe periodontitis were 64.4 mm2 and 27.6%, respectively; 54 (29.2%), 56 (30.3%), and 75 (40.5%) participants were stratified to the CAVI < 9, 9 ≤ CAVI <10, and CAVI ≥ 10 groups, respectively. After adjusting for potential confounders, the odds ratio of the prevalence and severity of arterial stiffness evaluated using CAVI was 1.06 [95% confidence interval (CI) 1.01 to 1.10] for PISA per 10 mm2 and 2.12 (95% CI 1.09 to 4.11) for severe periodontitis.

Conclusion: Periodontitis was associated with arterial stiffness among Japanese older adults. Further studies are needed to investigate whether arterial stiffness is an intermediate factor in the pathway between periodontitis and systemic diseases, including cardiovascular disease and dementia.

Keywords: aged; atherosclerosis; epidemiology; periodontal diseases.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ankle Brachial Index
  • Cross-Sectional Studies
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Odds Ratio
  • Periodontitis* / complications
  • Periodontitis* / epidemiology
  • Risk Factors
  • Vascular Stiffness*