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Editors & 8216;Consensus Report The AmericanJournal of Cardiology and Journal of Periodontology Editors& 8217;Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease r VincentE. *Associate Editor, The American Journal of Cardiology; Research Professor, University of Notre Dame, Notre Dame, IN; and Clinical Professor, Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX. †Editor-in-Chief, Journal of Periodontology, and Chief Scientific Officer, Interleukin Genetics, Waltham, MA. ‡Distinguished Professor and Associate Dean for Research, University of North Carolina School of Dentistry, Chapel Hill, NC. §Distinguished Professor, Departments of Oral Biology and Microbiology, University at Buffalo, State University of New York, Amherst, NY. k Associate Professor, Harvard Medical School, and Section Head of Clinical Research, Joslin Diabetes left, Boston, MA.

Pathophysiology Periodontitis begins with a microbial infection, followed by a host-mediated destruction of soft tissue caused by hyperactivatedor primed leukocytes and the genera- tionofcytokines, eicosanoids, and matrix metallopro- teinasesthat cause clinically significant connective tissue and bone destruction.3 Bacterial accumulations on the teeth are essential to the initiation and progres- sionof periodontitis. Cells that mediate immunity, such as neutrophils, playa major role in the host response against invading periodontopathogenicmicroorgan- isms. When bacterialbiofilms on the teeth are not dis- ruptedonaregular basis, ecologic changes lead to the emergence of a small set of gram-negative anaerobic

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