Patients with periodontitis are at a higher risk of stroke: A Taiwanese cohort study
Pei-Wei Hsu, Yen‐Wen Shen, Syamsiah Syam, Wen‐Miin Liang, Trong-Neng Wu, Jui‐Ting Hsu, Lih‐Jyh Fuh
Abstract
BACKGROUND: This study aimed to investigate the risk of stroke incidence in patients with periodontitis. METHODS: Data on patients diagnosed with periodontitis were collected from Taiwan's National Health Insurance Research Database and were matched (1:1) with patients without periodontitis between 2001 and 2010. A multivariable Cox survival model was used to predict stroke between patients with and without periodontitis, and the possibility of confounders. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to explore the risk of stroke in the case and control groups. Diseases found during the follow-up period were analyzed to determine possible effects on the study. A total of 282 560 periodontitis and nonperiodontitis patients were enrolled, with most subjects aged 40 to 59 years. RESULTS: The overall cumulative incidence of stroke was 2.14 times higher in periodontitis than in nonperiodontitis, and the highest HR was in the more than 80 years age group (HR = 9.30; 95% CI, 7.06-12.26). The multivariate Cox model indicated that the adjusted HR (aHR) between the case and control was 2.03 (95% CI, 1.99-2.08), and a higher aHR was associated with hypertension. Atherosclerosis, atrial fibrillation, obesity, kidney disease, anxiety, and gout discovered during follow-up also showed a potential risk of stroke in patients with periodontitis. CONCLUSION: Therefore, this study suggests a high risk of stroke in patients with periodontitis.