Periodontitis and arrhythmias: an emerging paradigm in cardiovascular medicine

Abstract

Periodontitis, a chronic inflammatory condition affecting the periodontal tissues and underlying bone, is now acknowledged as more than just a localized oral disease. With a global prevalence ranging from 20% to 50%, the implications of periodontitis extend beyond oral health, presenting significant concerns for public health. Research has demonstrated a strong association between periodontitis and cardiovascular disease, with shared risk factors encompassing age, smoking, socioeconomic status, and metabolic syndrome. Understanding the intricate relationship between periodontal disease and cardiovascular diseases, especially the development of arrhythmias like atrial fibrillation, is crucial. A comprehensive literature search using PubMed was conducted, employing keywords such as periodontitis, cardiovascular disease, cardiac arrhythmia, atrial fibrillation, and related terms. No exclusion criteria were used. This article reviews the current literature on the association between periodontitis and cardiovascular diseases, including atrial fibrillation. Atrial fibrillation, the most common cardiac arrhythmia, is influenced by various risk factors including alcohol consumption, advanced age, underlying heart and lung diseases, with poor oral hygiene emerging as a notable contributing factor. The direct invasion of endothelial cells by periodontal pathogens, the indirect pathway where periodontal disease triggers a systemic inflammatory response, and a shared genetic basis are three theories that explain this link. Patients with periodontal disease face an elevated risk of major cardiovascular events, especially arrhythmias, and recognizing this association is essential for healthcare practitioners to provide comprehensive care to patients with cardiac conditions.