The traditional and modifiable risk factors of coronary artery disease – a community-based cross-sectional study among 2 populations

Abstract

A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors. The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health. PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38–8.38]) and significant ( P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44–5.4) and non-significant ( P = .503) in the multivariate regression analysis. In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.

Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2

“…These associations have been explained by the presence of environmental and genetic risk factors, as well as by the presence of chronic inflammation [ 103 ]. It has already been reported that periodontal disease can lead to an increased risk of cardiovascular disease of 19%, and there may even be an increased relative risk of up to 44% if patients with periodontitis are over 65 years of age [ 104 ]. Comparative studies have been conducted in patients who have shown a significantly higher prevalence of periodontal disease in patients with COPD compared to healthy individuals [ 101 , 105 ].…”

Prevalence and risk factors of periodontal disease among rural and urban residents of a south Indian city: A cross-sectional study

“…The methods of the oral examination and scoring criteria were discussed in detail in an article published previously. [ 21 ] Using standardized techniques, the periodontal health condition of participants from the Thiruvananthapuram district of Kerala’s rural and urban areas was assessed. The periodontal health of the teeth and oral hygiene were evaluated using a modification of the Ramfjord PD index.…”

“…The mesial, distal, buccal, and lingual aspects of each indexed tooth were examined, and the highest possible score was noted. [ 21 ] The periodontal condition of the teeth was assessed using a standard periodontal probe graded in millimeters, which gauged the clinical attachment loss by measuring between the tooth’s cementoenamel junction and the bottom of the gingival sulcus. The gingival and periodontal components of the PD index were assessed.…”

“…PD index scores of 4, 5, and 6 were assigned based on the grading of periodontal attachment loss between ≥3 and >6 mm. [ 21 ] Oral hygiene status was assessed based on a modification of the calculus component of the Ramfjords PD index. The calculus score was graded as 1, 2, and 3 based on the amount of supragingival and subgingival calculus on the buccal and lingual surfaces of the six indexed teeth.…”