To the Editor
Recently, we read the article “Association Between ‘Life's Essential 8’ and Periodontitis: A Cross-Sectional Study From the NHANES Database”1 with great interest. Life's Essential 8 (LE8) is a measure of cardiovascular health (CVH) proposed by the American Heart Association in 2010, which highlights the important factors in maintaining and improving CVH.2 In this study, the authors enrolled 5106 patients to investigate the effects of health behaviours and health factors that provide an important basis for the early detection and treatment of periodontitis.
LE8 is associated with a variety of cardiac diseases. Li et al3 found that in cardiovascular disease, higher LE8 scores can manifest as significantly reduced risk of coronary heart disease (CHD) and stroke, the effect of which is more significant in women and young adults. Higher LE8 scores are also associated with a reduction in the incidence of atrial fibrillation (AF).4 Current studies have shown periodontitis to be an important risk factor for CHD and AF.5, 6 Some factors that predispose to cardiovascular disease, such as smoking, diabetes, and mental health disorders, are also important risk factors for periodontitis.7 In addition, some drugs for CHD, such as statins, also help improve gingival health.8 Therefore, it is highly desirable to investigate the association amongst CVH, CVD, and periodontitis.
Lu et al1 reported a negative correlation between LE8 score and periodontitis, proposing that promoting improved CVH may be beneficial in reducing the burden of periodontitis. Qu and Zhang9 also explored the association between CVH and periodontitis using LE8 score; they proposed that better CVH is associated with reduced periodontitis in adults and that this effect is more significant in people with lower socio-economic status. Moreover, Chen et al10 found that high LE8 scores were associated with lower odds of periodontitis in a larger cohort, especially in patients without CHD.
Although the findings are very meaningful, we still have some constructive opinions, which we hope will be helpful:
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1.
In the study population, only patients with a history of CHD were selected. It may be better to include patients with AF.
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2.
Treatment for CHD may affect the LE8 score and the development of periodontitis, and it may be better to consider the course of CHD and drug treatment options.
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3.
This study is a retrospective study, and prospective studies at other centers are needed to confirm these findings.
Conflict of interest
None disclosed.
REFERENCES
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