Association Between Periodontitis and Hemorrhagic Stroke Among Koreans: A Case‐Control Study

Abstract

Background: Several studies suggested that periodontitis is a risk factor for stroke, but the relationship between periodontitis and hemorrhagic stroke has not been widely reported. This study aims to evaluate the association between periodontitis and hemorrhagic stroke and to identify the risk group for this association. Methods: We recruited 165 patients who were diagnosed via computed tomography brain imaging as having had a hemorrhagic stroke and 214 non‐stroke control subjects for a case‐control study. All participants underwent a clinical periodontal examination using clinical attachment level (CAL) as a marker. Information about sociodemographic factors, behavioral factors, systemic health, and a familial history of systemic health was gathered through an interview using structured questionnaires. The association between periodontitis and hemorrhagic stroke was evaluated using multivariate logistic regression analyses with adjustment for age, gender, income, education, hypertension, diabetes, body mass index, cardiac disease, familial hypertension history, familial diabetes history, familial cardiac disease history, smoking, and alcohol consumption. Subgroup analyses were also performed to investigate potential risk groups. Results: After controlling for potential confounders, periodontitis (CAL ≥6 mm) was found to be significantly associated with hemorrhagic stroke (odds ratio: 2.5; 95% confidence interval: 1.1 to 5.6), but this association did not exhibit a dose‐dependent response for periodontitis (percentile of sites of periodontal pockets with CAL ≥5 mm among total probed pockets). The association between periodontitis (CAL ≥6 mm) and hemorrhagic stroke was significant for males, patients who had a lower income than control subjects, obese patients, and patients without diabetes. Conclusions: Periodontitis may be an independent risk factor for hemorrhagic stroke. Risk groups include males, patients without diabetes, and obese subjects.

Association between periodontal disease and stroke

“…There were six prospective 9-14 and seven retrospective studies. [15][16][17][18][19][20][21] Definitions of periodontitis were taken directly from the included studies. Periodontal inflammation was assessed by different parameters such as clinical attachment level (CAL), extent of attachment loss, number of teeth loss, bone loss, and self-reported presence or absence of periodontal disease.…”

A systematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke

“…25,27,32,33,41 Patients with stroke were significantly less likely to have an annual dental visit [odds ratio: 0.493, 95% CI (0.372, 0.652), p < 0.0001, fixed effect; 0.480, 95% CI (0.249, 0.924), p = 0.028, random effect, control group as reference] (Fig. 5).…”

Prise en charge des foyers infectieux bucco-dentaires

“…Selon une autre méta-analyse [65], la prévalence et l'incidence des coronaropathies sont significativement augmentées chez les patients atteints de parodontites. Une autre étude [66] a montré que la maladie parodontale était également un facteur de risque des accidents vasculaires cérébraux, particulièrement les accidents vasculaires cérébraux non hémorragiques.…”