Periodontal Disease and Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association

Since the publication of the 2012 American Heart Association scientific statement on the association between periodontal disease and atherosclerotic cardiovascular disease, the body of literature on this topic has grown substantially. Atherosclerotic cardiovascular disease is the leading cause of death globally, and understanding contributors and potential targets to decrease this risk is paramount. This updated scientific statement synthesizes new evidence concerning an association between periodontal disease and atherosclerotic cardiovascular disease, including findings from Mendelian randomization studies, interventions targeting periodontal disease, and studies exploring systemic markers, such as inflammatory cytokines and vascular measures. The scientific statement also highlights disparities in the prevalence of periodontal disease, particularly among underresourced populations; explores potential mechanisms linking periodontal disease with cardiovascular outcomes through direct pathways, such as bacteremia, and indirect pathways, such as chronic systemic inflammation; and identifies areas needing further clarification that would benefit from additional research.