Several studies unanimously showed that acute infection is a risk factor for cerebrovascular ischemia.

In contrast, the role of chronic or recurrent infection as a potential stroke risk factor is mainly unknown.

Presently, there is increasing evidence that chronic bronchitis and chronic infection with microbial agents such as Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus may be associated with cardiovascular disease and atherogenesis.

Furthermore, poor dental health was shown to increase the risk for coronary heart disease and acute myocardial infarction.

Caries and periodontitis are the most important chronic dental diseases, and they both are bacterial infections.

In a case-control study, poor dental status was a risk factor for myocardial infarction independent from age, social class, smoking, hyperlipidemia, and diabetes mellitus. Further results indicated a significant association between chronic dental infection and severity of coronary atherosclerosis. Other studies found the number of missing teeth and poor oral hygiene and periodontitis but not caries to be independently associated with coronary heart disease. Few studies addressed the role of dental infection in cerebrovascular disease. In a case-control study with ischemic stroke patients under the age of years, male but not female patients had more severe dental infection than respective control subjects from the community. A recently published cohort study with men followed for more than years found periodontal disease to be associated with coronary heart disease and stroke independent from other risk factors and education.

Published by the American Heart Association

The Journal STROKE (1997, 28:1724)