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Periodontal bacteria and hypertension: the oral infections and vascular disease epidemiology study (INVEST)

Desvarieux, Moïsea,b,c; Demmer, Ryan Ta; Jacobs, David R; Jr, d; Rundek, Tatjanae; Boden-Albala, Bernadettef,g; Sacco, Ralph Le; Papapanou, Panos Nh

doi: 10.1097/HJH.0b013e328338cd36
Original papers: Epidemiology

Objective Chronic infections, including periodontal infections, may predispose to cardiovascular disease. We investigated the relationship between periodontal microbiota and hypertension.

Methods and results Six hundred and fifty-three dentate men and women with no history of stroke or myocardial infarction were enrolled in INVEST. We collected 4533 subgingival plaque samples (average of seven samples per participant). These were quantitatively assessed for 11 periodontal bacteria using DNA–DNA checkerboard hybridization. Cardiovascular risk factor measurements were obtained. Blood pressure and hypertension (SBP ≥140 mmHg, DBP ≥90 mmHg or taking antihypertensive medication, or self-reported history) were each regressed on the level of bacteria: considered causative of periodontal disease (etiologic bacterial burden); associated with periodontal disease (putative bacterial burden); and associated with periodontal health (health-associated bacterial burden). All analyses were adjusted for age, race/ethnicity, sex, education, BMI, smoking, diabetes, low-density lipoprotein and high-density lipoprotein cholesterol. Etiologic bacterial burden was positively associated with both blood pressure and prevalent hypertension. Comparing the highest and lowest tertiles of etiologic bacterial burden, SBP was 9 mmHg higher, DBP was 5 mmHg higher (P for linear trend was less than 0.001 in each case), and the odds ratio for prevalent hypertension was 3.05 (95% confidence interval 1.60–5.82) after multivariable adjustment.

Conclusion Our data provide evidence of a direct relationship between the levels of subgingival periodontal bacteria and both SBP and DBP as well as hypertension prevalence.

aDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA

bINSERM, UMR-S 707, Universite Pierre et Marie Curie-Paris 6, UMR S 707, Paris, France

cEcole des Hautes Etudes en Sante Publique, Paris et Rennes, France

dDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA, Also affiliated with the Department of Nutrition, University of Oslo, Oslo, Norway

eDepartment of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA

fDepartment of Neurology, Columbia University College of Physicians and Surgeons, USA

gDepartment of Sociomedical Sciences, Mailman School of Public Health, USA

hDivision of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Columbia University, New York, New York, USA

Received 6 December, 2009

Revised 9 February, 2010

Accepted 17 February, 2010

Correspondence to Moïse Desvarieux, MD, PhD, 722 W. 168th Street, 7th Floor, New York, NY 10032, USA Tel: +1 212 305 9339; fax: +1 212 342 2756; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.