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The surprising link between oral bacteria and heart disease.

Episode Summary: Dr. Pekka Karhunen explains the connection between oral bacteria, cholesterol, and cardiovascular disease, discussing how oxidized LDL cholesterol triggers inflammation in arteries, how bacteria from the mouth can infiltrate arterial plaques to form biofilms, and the implications for heart disease prevention through lifestyle changes like better oral hygiene.

About the guest: Pekka Karhunen, MD, PhD is a medical doctor and forensic pathologist with decades of experience, specializing in cardiovascular diseases. He has created a unique biobank of coronary arteries from over 10,000 autopsies conducted in Finland. His research focuses on the role of bacteria in atherosclerosis, particularly through studying coronary artery plaques.

Discussion Points:

• Cholesterol is essential for life, but oxidized low-density lipoprotein (LDL) cholesterol is seen as a foreign substance by the immune system, leading to chronic inflammation in coronary arteries.
• Macrophages ingest oxidized LDL, turning into dysfunctional foam cells that contribute to plaque buildup, known as atheromas, in arteries.
• Plaque rupture, potentially caused by increased pressure from cholesterol accumulation or hemorrhage within the plaque, can trigger heart attacks.
• Bacteria, especially from the mouth, can enter arterial plaques via bacteremia (e.g., from dental procedures) and form biofilms, evading immune detection.
• Biofilms in plaques, made of extracellular matrix like polysaccharides, protect bacteria and may contribute to plaque instability or calcification over time.
• Poor oral hygiene is linked to higher cardiovascular disease risk, as bacteria from dental infections can enter plaques, suggesting dental care as a preventive measure.
• Karhunen’s research found oral bacteria, like Viridans streptococci, in coronary plaques, with unpublished data also detecting gut and skin bacteria, indicating diverse bacterial involvement.

Related content:

• M&M 247: Cholesterol: Immune Benefits, Heart Health, Statins & Research Malpractice | Uffe Ravnskov

*Not medical advice.

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