Background and objectives: Hypertension and diabetes mellitus (DM) have been two major causes of stroke, while the impact of periodontitis on nonfatal ischemic strokes (NFIS) is still underestimated. Hence, we aimed to evaluate the association of periodontitis with NFIS and to compare its impacts with those of hypertension and DM.
Methods: A case-control study was performed with 143 hospitalized NFIS cases and 214 population controls. Medical specialists diagnosed NFIS using brain imaging with CT and MRI. A dentist assessed periodontitis using the clinical attachment level with a UNC-15 manual probe. Potential confounders were interviewed using systematic questionnaires. Multivariable logistic regression analyses including subgroup analyses were applied.
Results: After controlling for potential confounders, periodontitis was strongly associated with NFIS. The adjusted odds ratio (AOR) was 6.4 for periodontitis. Periodontitis has the same association as hypertension. AOR of periodontitis was 2.5 times higher than that of DM. In 40-59 years old adults and smokers, periodontitis showed higher association than hypertension and DM. In females and non-smokers, periodontitis had lower association than hypertension, but higher than DM. Hypertension and diabetes were synergistic to periodontitis.
Conclusions: Overall, periodontitis had the almost same strength of the association with NFIS as hypertension, but higher than DM.