A new study offers more evidence of a link between oral and heart health. It found that high-dose statins can reduce gum inflammation in heart disease patients in as little as 4 weeks.
The researchers report their findings in the latest online issue of the Journal of the American College of Cardiology.
Statins are commonly prescribed for lowering blood cholesterol. Although we need some cholesterol for good health, too much of the fatty substance clogs up arteries and causes atherosclerosis, an inflammatory condition that leads to heart attacks, stroke, and peripheral vascular disease.
Co-author Dr. Ahmed Tawkol, co-director of the Cardiac Imaging Trials Program at Massachusetts General Hospital and Harvard Medical School, says:
"Periodontal disease is characterized by chronic gum inflammation and affects approximately 50% of the US adult population. Periodontitis and atherosclerosis are both primarily driven by inflammation. These inflammatory conditions tend to co-exist within individuals and their biologies may be intertwined."
For their study, the researchers recruited 83 adult patients with heart disease or a high risk for heart disease attending several medical centers and randomly assigned them either to take a daily dose of 80 mg of atorvastatin or a 10 mg dose of the drug for 12 weeks.
The study was a double-blind one, that is, neither the patients nor the doctors administering the statins knew which dose they were handling.
The patients underwent PET/CT scans before starting the medication, after taking it for 4 weeks and also at the end of the 12-week trial.
The final analysis included 59 patients, and it showed that the high-dose group experienced a significant reduction in gum inflammation at the 4-week scan.
Plus, the researchers also noted that the reduction in gum inflammation was closely linked to reduction in atherosclerosis.
They suggest these findings show further evidence of a link between oral and heart health, namely that periodontal disease is closely associated with atherosclerosis, and treatments that improve one will also improve the other condition.
And they propose there may be some truth in the idea that oral hygiene that reduces gum inflammation may also reduce inflammation in the arteries.
Dr. Tawakol says doctors should think about the possibility that statins do more than lower cholesterol when discussing treatment options with their patients.
Plus, he urges patients with heart disease or who have had strokes to tell their doctor if they have gum disease and to take care to follow guidelines about how to treat it.
The authors also note that this was a small study, and they call for larger randomized studies to examine the underlying mechanisms that tie localized inflammation in the gum and other tissues to inflammation in the arteries.
Dr. Michael Blaha, of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, notes in an accompanying editorial that in the past, statins were seen only as cholesterol busters for treating patients with high blood levels of the fatty substance.
Now, however, he sees new potential:
"A more modern perspective paints statins as cardiovascular risk-reducing medications with multiple possible mechanisms of action," and this new study "has tremendous potential implications for our philosophy toward statin allocation in primary prevention and future testing of new anti-atherosclerotic drugs."