Tooth Loss, Obesity, and Depression May All Predict Cardiovascular Disease

as reported in Patient Care Online, October 2003

The American Stroke Association reports that tooth loss caused by gum disease may be a marker of subclinical cardiovascular disease (CVD) and atherosclerosis based on preliminary findings from the Oral Infections and Vascular Disease Epidemiology Study (INVEST).

While previous studies had suggested a link between gum disease and adverse events such as heart attack and stroke, INVEST addresses whether missing teeth correlate with the amount of plaque in neck arteries. The results show that the prevalence of carotid plaque increased with the number of missing teeth.

Among those missing 0 to 9 teeth, 45% had atherosclerosis; about 60% of those with 10 or more missing teeth had the condition. Researchers speculate that tooth loss is an indicator of chronic infection or inflammation of the gums, which predisposes to CVD. They caution, however, that not all tooth loss indicates an incidence of severe gum disease because tooth removal practices vary.

Being overweight and clinically depressed may also work together to provoke the chronic low-level inflammation associated with atherosclerosis and increased risk of heart disease, according to British researchers.

Among a large group of middle-aged men, those who were obese had significantly higher concentrations of C-reactive protein (CRP), a signal of artery inflammation, compared with non-obese men. CRP levels were also higher in the more depressed than in the less depressed obese men. Depression did not affect CRP levels among non-obese men, however, suggesting that a combination of obesity and depression may elevate risk.

The association between obesity and depression remained strong even after accounting for other factors that can affect CRP levels, including smoking, alcohol consumption, and physical activity, according to the researchers.