The Lanyon Building
The Lanyon Building

A Longitudinal Investigation of Periodontal Disease as a Risk Factor for Coronary Heart Disease and Stroke in the PRIME STUDY

The Belfast PRIME study was set up by Professor Alun Evans to identify the reasons for the high levels of heart disease in men in Northern Ireland. Between 1991 and 1994 a group of 2745 men in Northern Ireland aged between 50 and 60 years was recruited. The men provided detailed information on their health, diet, physical activity, smoking behaviour and alcohol consumption. They had a baseline examination which included measurements of their height, weight, blood pressure, lung function and an ECG. Since the initial examination the development of heart disease and stroke in this group of men has been closely monitored.

The men in PRIME have been contacted at regular intervals and any changes in their medical history noted. The study is located at the RVH in close proximity to the Regional Medical Cardiology Centre which provides treatment for the majority of those in PRIME who have developed heart problems.  Most such studies have stopped after 10 years, however, international experts have suggested that there are good scientific reasons for prolonged (20-year) follow-up in studies of heart disease and stroke such as PRIME. The steady reduction in the early onset of heart disease in recent years, due to improvements in public health and better focus on prevention, mean that the effects of atherosclerosis are presenting ever later in life resulting in the need for longer follow-up.  PRIME is ideally placed because the stability of the local population and the willingness of the men to co-operate have resulted in excellent levels of compliance.

This study is also investigating the relationship between periodontal disease and cardiovascular disease.  Periodontal disease is what is commonly referred to as gum disease and causes damage to the bone supporting the teeth and ultimately may lead to the loss of some or all the teeth.  The study is looking at whether the specific bacteria in dental plaque are associated with heart disease or stroke

Periodontitis is widely known as gum disease; it is an inflammatory condition caused by the bacteria which build up on the surface of the teeth known as dental plaque. Almost two-thirds of those aged 65 or older have either moderate or severe periodontitis. Studies have suggested that it could increase the risk of later dementia.  There is also evidence that nutritional status impacts upon cognition. We aim to carry out a cognitive assessment, along with analysis of fresh and stored blood samples and genetic analysis to ascertain if prior periodontitis and/or inflammation increase the risk of dementia.  Participants are asked to complete short questionnaires about general health, dental health and diet; and anthropometric measurements (weight, height, waist circumference and grip strength) These additional measures will allow complete assessment of dental, cognitive status and nutrition during the 25-year follow-up of men in PRIME.

PRIME is a unique study and has improved our understanding of the reasons why some men get disease and some do not.