Periodontitis as a risk factor in patients with ischemic heart disease.

Cardiovascular disease, and particularly ischemic heart disease (IHD), constitutes one of the principal causes of mortality in the western world. Interest has recently increased in the relationship between IHD and different infectious processes as triggering factors of the former, such as Chlamydia pneumoniae and Helicobacter pylori infection. Periodontitis has also been related to an increased risk of coronary disease, since both disorders share common characteristics such as patient age and sex, and a smoking habit, among other aspects. There are many similarities between vascular pathology induced by bacteria and the natural history of atherogenesis. The principal mechanism of action underlying periodontitis and IHD centers on the effect of bacteria and their endotoxins upon inflammatory reaction, hemostasia and lipid metabolic alterations. However, some authors are of the opinion that periodontitis constitutes an epiphenomenon, and that further studies are needed to clarify the cause-effect relation between these two multifactor pathologies.