Table 2. Hazard ratio (95% confidence intervals) for the relation of baseline oral health with health outcomes in ADVANCE (N=10,958 men and women).
| Adjustments | Number of natural teeth | P-trend | Days of bleeding gums/year | P-trend | ||||
|---|---|---|---|---|---|---|---|---|
| >=22* (n=4476) | 1-21 (n=4174) | 0 (n=2308) | 0 days* (n=9553) | <12 days (n= 686) | >=12 days (n= 719) | |||
| Total mortality (1011 deaths) | ||||||||
| Age, sex + treatment (‘base’ model) | 1 (ref) | 1.41 (1.20, 1.65) | 1.78 (1.50, 2.11) | 0.001 | 1 (ref) | 1.03 (0.79, 1.35) | 0.92 (0.69, 1.22) | 0.67 |
| Base + ethnicity | 1 | 1.44 (1.23, 1.69) | 1.84 (1.54, 2.20) | 0.001 | 1 | 1.03 (0.79, 1.35) | 0.92 (0.69, 1.22) | 0.66 |
| Base + quality of life | 1 | 1.36 (1.16, 1.59) | 1.70 (1.44, 2.02) | 0.001 | 1 | 1.02 (0.78, 1.34) | 0.87 (0.66, 1.16) | 0.45 |
| Base + existing illness | 1 | 1.36 (1.16, 1.59) | 1.70 (1.44, 2.02) | 0.001 | 1 | 1.00 (0.76, 1.31) | 0.94 (0.70, 1.25) | 0.69 |
| Base + behavioural CVD risk factors | 1 | 1.38 (1.18, 1.62) | 1.73 (1.46, 2.05) | 0.001 | 1 | 1.05 (0.80, 1.37) | 0.95 (0.71, 1.26) | 0.86 |
| Base + physiological CVD risk factors | 1 | 1.36 (1.16, 1.59) | 1.71 (1.44, 2.03) | 0.001 | 1 | 1.05 (0.80, 1.38) | 0.93 (0.70, 1.24) | 0.77 |
| Base + psychological CVD risk factors | 1 | 1.33 (1.14, 1.56) | 1.66 (1.40, 1.97) | 0.001 | 1 | 1.03 (0.79, 1.35) | 0.88 (0.66, 1.17) | 0.47 |
| Base + socio-economic CVD risk factors | 1 | 1.40 (1.20, 1.63) | 1.76 (1.48, 2.08) | 0.001 | 1 | 1.06 (0.81, 1.38) | 0.95 (0.71, 1.26) | 0.86 |
| Multiple adjusted | 1 | 1.24 (1.05, 1.46) | 1.48 (1.24, 1.78) | 0.001 | 1 | 1.08 (0.82, 1.41) | 0.96 (0.72, 1.28) | 1.00 |
| All CHD events (1119 events) | ||||||||
| Age, sex + treatment (‘base’ model) | 1 (ref) | 1.27 (1.11, 1.46) | 1.38 (1.17, 1.62) | 0.001 | 1 (ref) | 1.21 (0.96, 1.52) | 1.07 (0.84, 1.36) | 0.26 |
| Base + ethnicity | 1 | 1.17 (1.01, 1.35) | 1.22 (1.03, 1.45) | 0.02 | 1 | 1.21 (0.96, 1.52) | 1.04 (0.81, 1.32) | 0.38 |
| Base + quality of life | 1 | 1.24 (1.08, 1.42) | 1.32 (1.13, 1.55) | 0.001 | 1 | 1.19 (0.95, 1.50) | 1.03 (0.81, 1.31) | 0.44 |
| Base + existing illness | 1 | 1.21 (1.05, 1.39) | 1.26 (1.07, 1.49) | 0.003 | 1 | 1.22 (0.97, 1.54) | 1.08 (0.85, 1.38) | 0.22 |
| Base + behavioural CVD risk factors | 1 | 1.28 (1.11, 1.47) | 1.39 (1.18, 1.64) | 0.001 | 1 | 1.21 (0.96, 1.52) | 1.06 (0.83, 1.35) | 0.29 |
| Base + physiological CVD risk factors | 1 | 1.20 (1.05, 1.38) | 1.25 (1.06, 1.47) | 0.004 | 1 | 1.23 (0.98, 1.54) | 1.06 (0.83, 1.35) | 0.27 |
| Base + psychological CVD risk factors | 1 | 1.23 (1.07, 1.41) | 1.31 (1.12, 1.54) | 0.001 | 1 | 1.19 (0.95, 1.50) | 1.03 (0.81, 1.31) | 0.44 |
| Base + socio-economic CVD risk factors | 1 | 1.27 (1.11, 1.46) | 1.37 (1.16, 1.61) | 0.001 | 1 | 1.22 (0.97, 1.54) | 1.09 (0.85, 1.39) | 0.20 |
| Multiple adjusted | 1 | 1.24 (0.98, 1.56) | 1.04 (0.81, 1.32) | 0.34 | 1 | 1.24 (0.98, 1.56) | 1.04 (0.81, 1.32) | 0.34 |
| All cerebrovascular disease events (668 events) | ||||||||
| Age, sex + treatment (‘base’ model) | 1 (ref) | 1.10 (0.92, 1.31) | 0.93 (0.75, 1.15) | 0.68 | 1 (ref) | 1.18 (0.88, 1.60) | 1.08 (0.79, 1.47) | 0.39 |
| Base + ethnicity | 1 | 1.34 (1.12, 1.60) | 1.26 (1.00, 1.58) | 0.02 | 1 | 1.19 (0.88, 1.61) | 1.15 (0.84, 1.58) | 0.21 |
| Base + quality of life | 1 | 1.07 (0.90, 1.28) | 0.90 (0.73, 1.12) | 0.47 | 1 | 1.17 (0.87, 1.59) | 1.05 (0.77, 1.43) | 0.51 |
| Base + existing illness | 1 | 1.06 (0.89, 1.27) | 0.88 (0.71, 1.09) | 0.35 | 1 | 1.19 (0.88, 1.60) | 1.08 (0.79, 1.48) | 0.38 |
| Base + behavioural CVD risk factors | 1 | 1.09 (0.92, 1.30) | 0.93 (0.75, 1.15) | 0.66 | 1 | 1.19 (0.88, 1.61) | 1.08 (0.79, 1.48) | 0.38 |
| Base + physiological CVD risk factors | 1 | 1.12 (0.94, 1.33) | 0.95 (0.77, 1.19) | 0.87 | 1 | 1.22 (0.90, 1.64) | 1.13 (0.82, 1.54) | 0.25 |
| Base + psychological CVD risk factors | 1 | 1.06 (0.89, 1.26) | 0.89 (0.72, 1.10) | 0.39 | 1 | 1.18 (0.87, 1.59) | 1.05 (0.77, 1.43) | 0.51 |
| Base + socio-economic CVD risk factors | 1 | 1.10 (0.92, 1.31) | 0.93 (0.75, 1.15) | 0.68 | 1 | 1.20 (0.89, 1.62) | 1.11 (0.81, 1.52) | 0.20 |
| Multiple adjusted | 1 | 1.24 (1.03, 1.49) | 1.10 (0.87, 1.38) | 0.29 | 1 | 1.24 (0.91, 1.67) | 1.16 (0.84, 1.58) | 0.18 |
| CVD mortality (536 deaths) | ||||||||
| Age, sex + treatment (‘base’ model) | 1 (ref) | 1.53 (1.24, 1.89) | 1.67 (1.32, 2.12) | 0.001 | 1 (ref) | 1.21 (0.86, 1.70) | 1.01 (0.69, 1.48) | 0.62 |
| Base + ethnicity | 1 | 1.58 (1.27, 1.97) | 1.76 (1.37, 2.27) | 0.001 | 1 | 1.21 (0.86, 1.71) | 1.01 (0.69, 1.47) | 0.63 |
| Base + quality of life | 1 | 1.46 (1.18, 1.80) | 1.58 (1.25, 2.00) | 0.001 | 1 | 1.20 (0.85, 1.69) | 0.95 (0.65, 1.39) | 0.87 |
| Base + existing illness | 1 | 1.44 (1.16, 1.78) | 1.55 (1.22, 1.96) | 0.001 | 1 | 1.16 (0.83, 1.64) | 1.04 (0.71, 1.52) | 0.58 |
| Base + behavioural CVD risk factors | 1 | 1.51 (1.22, 1.87) | 1.66 (1.30, 2.10) | 0.001 | 1 | 1.22 (0.87, 1.73) | 1.02 (0.70, 1.49) | 0.57 |
| Base + physiological CVD risk factors | 1 | 1.47 (1.19, 1.82) | 1.60 (1.26, 2.04) | 0.001 | 1 | 1.24 (0.88, 1.76) | 1.02 (0.70, 1.49) | 0.55 |
| Base + psychological CVD risk factors | 1 | 1.43 (1.16, 1.77) | 1.54 (1.21, 1.95) | 0.001 | 1 | 1.21 (0.86, 1.71) | 0.95 (0.65, 1.39) | 0.85 |
| Base + socio-economic CVD risk factors | 1 | 1.52 (1.23, 1.89) | 1.66 (1.31, 2.11) | 0.001 | 1 | 1.24 (0.88, 1.76) | 1.05 (0.72, 1.53) | 0.46 |
| Multiple adjusted | 1 | 1.32 (1.06, 1.65) | 1.35 (1.05, 1.74) | 0.02 | 1 | 1.28 (0.91, 1.81) | 1.04 (0.71, 1.52) | 0.47 |
| Non-CVD mortality (475 deaths) | ||||||||
| Age, sex + treatment (‘base’ model) | 1 (ref) | 1.28 (1.02, 1.61) | 1.90 (1.49, 2.42) | 0.001 | 1 (ref) | 0.83 (0.54, 1.28) | 0.81 (0.52, 1.27) | 0.25 |
| Base + ethnicity | 1 | 1.29 (1.01, 1.63) | 1.93 (1.49, 2.49) | 0.001 | 1 | 0.84 (0.55, 1.29) | 0.81 (0.52, 1.26) | 0.24 |
| Base + quality of life | 1 | 1.24 (0.99, 1.57) | 1.84 (1.45, 2.35) | 0.001 | 1 | 0.83 (0.54, 1.27) | 0.79 (0.51, 1.22) | 0.19 |
| Base + existing illness | 1 | 1.27 (1.01, 1.60) | 1.88 (1.48, 2.40) | 0.001 | 1 | 0.81 (0.53, 1.25) | 0.82 (0.53, 1.27) | 0.24 |
| Base + behavioural CVD risk factors | 1 | 1.24 (0.99, 1.57) | 1.82 (1.42, 2.32) | 0.001 | 1 | 0.85 (0.55, 1.31) | 0.86 (0.55, 1.34) | 0.37 |
| Base + physiological CVD risk factors | 1 | 1.24 (0.98, 1.56) | 1.84 (1.44, 2.35) | 0.001 | 1 | 0.85 (0.55, 1.30) | 0.83 (0.53, 1.28) | 0.29 |
| Base + psychological CVD risk factors | 1 | 1.23 (0.97, 1.55) | 1.81 (1.42, 2.30) | 0.001 | 1 | 0.83 (0.54, 1.28) | 0.79 (0.51, 1.22) | 0.19 |
| Base + socio-economic CVD risk factors | 1 | 1.26 (1.00, 1.59) | 1.86 (1.46, 2.37) | 0.001 | 1 | 0.85 (0.55, 1.31) | 0.83 (0.53, 1.29) | 0.29 |
| Multiple adjusted | 1 | 1.15 (0.91, 1.47) | 1.64 (1.26, 2.13) | 0.001 | 1 | 0.86 (0.56, 1.33) | 0.86 (0.56, 1.35) | 0.40 |
Of the 1119 CHD events, 327 were fatal and 792 non-fatal; of the 668 cerebrovascular events, 66 were fatal and 602 non-fatal. All analyses are adjusted for age, sex and randomized treatment allocation. Existing illness: comprises one or more of the following: use of Metformin/beta-blockers, history of macrovascular or microvascular disease, or those requiring assistance with daily activities, plus diabetes duration; Behavioural CVD risk factors: Cigarette smoking, alcohol intake, vigorous physical activity in previous week; Physiological CVD risk factors: Haemoglobin A1c, Creatinine, BMI, total cholesterol, HDL cholesterol, resting heart rate, SBP, DBP; Psychological CVD risk factors: Quality of life (EQ-5d score), and Mini Mental State Exam Score; Socio-economic CVD risk factors: Age at completion of highest level of education, height; Multiple adjusted: All above covariates.
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better oral health