Published Online
on February 10, 2003

A more recent version of this article appeared on March 1, 2003

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Submitted on September 26, 2002
Revised on October 22, 2002

Association Between Periodontal Disease and Left Ventricle Mass in Essential Hypertension

Fabio Angeli^*; Paolo Verdecchia; Concetta Pellegrino; Rosaria Giulia Pellegrino; Giacinto Pellegrino; Lucio Prosciutti; Claudia Giannoni; Stefano Cianetti; and Maurizio Bentivoglio

From Dipartimento Malattie Cardiovascolari, Università degli Studi di Perugia and Ospedale R. Silvestrini (F.A., P.V., L.P., M.B.), Perugia; and Università degli Studi di Perugia, Corso di Laurea in Odontoiatria e Protesi Dentaria (C.P., R.G.P., G.P., C.G., S.C.), Perugia, Italy.

^* To whom correspondence should be addressed. E-mail: fangeli{at}cardionet.it.

Abstract--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/height^2.7) 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 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.

Key words: hypertension, essential • left ventricular hypertrophy • periodontal disease • left ventricular mass • echocardiography

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