Group 3 Pulmonary Hypertension: From Bench to Bedside



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Flossing Just Once A Week May Lower Stroke Risk

Flossing your teeth at least once a week may reduce your risk of stroke and irregular heartbeat, according to a preliminary study to be presented next week at the American Stroke Association's International Stroke Conference 2025 in Los Angeles.

[1]

"Flossing was also linked to better overall health, including lower blood pressure, healthier cholesterol levels, and lower chances of diabetes," says study lead author Souvik Sen, MD, chair of the neurology department at the University of South Carolina School of Medicine and a neurologist at Prisma Health in Columbia, South Carolina.

Exploring the Link Between Oral and Heart Health

The researchers were looking to find out which oral hygiene behavior — dental flossing, brushing, or regular dentist visits — had the greatest impact on stroke prevention.

The study included about 6,300 people. About 65 percent said they flossed.

A detailed questionnaire gathered information about oral hygiene habits and dental visits, as well health status, including high blood pressure, diabetes, high cholesterol, smoking, and body mass index.

During the 25 years of follow-up, 434 participants had strokes, of which 147 were larger artery brain clots, 97 were heart-driven clots, and 95 were hardening of the smaller arteries. About 1,300 people experienced atrial fibrillation (also called afib), an irregular and usually very rapid heart rhythm.

Flossing Benefits May Extend Beyond Your Gums

In the new research, which hasn't yet been peer reviewed, flossing at least once a week was linked to the following benefits:

Researchers found a lowered risk associated with flossing whether or not people regularly brushed their teeth or got routine dental care.

Why Does Flossing Protect the Heart and Brain? This isn't the first study to find a link between oral health and stroke. Because of the connection, the American Heart Association recommends that people see a dentist and get regular dental checkups as part of a heart-healthy lifestyle.

[4]

But researchers were surprised by the reduction in atrial fibrillation risk. A recent study suggests that at least 10.5 million Americans have afib, much higher than previously thought.

[5]

Why would flossing specifically lower this risk? "Flossing leads to reduction in oral infections such as gum disease and caries [cavities]," says Dr. Sen. This results in less inflammation, which has been tied to atrial fibrillation by several possible mechanisms, he says:

  • Inflammation and oxidative stress promote atrial fibrosis (scarring) and structural remodeling, disrupting normal electrical conduction in the heart.
  • Inflammatory stress impacts heart rate variability and increases the risk of atrial fibrillation.
  • Inflammation damages the endothelial lining of blood vessels, which in turn increases the risk of blood clots. Afib patients with chronic inflammation have a higher risk of stroke and embolism.

    • Inflammation is also tied to hardening of the blood vessels (called atherosclerosis) that can lead to stroke and heart attack, says Sen.

    Preliminary Study Doesn't Conclusively Prove That Flossing Lowers Heart Disease Risk

    Because this study was observational — it collected data on existing dental hygiene habits — it doesn't prove that flossing is directly responsible for the reduction in stroke and afib risks.

    "Flossing is great for your teeth, but linking it directly to stroke prevention is tricky," says Harlan Krumholz, MD, a professor of medicine and director of the Yale Center for Outcomes Research and Evaluation in New Haven, Connecticut. Dr. Krumholz was not involved in the study.

    "People who floss regularly often take better care of their health in general — eating well, exercising, and keeping up with medical care — so it's hard to say whether flossing itself lowers stroke risk, or if it's just part of an overall healthy lifestyle. Studies like this are interesting, but we need to know more to prove cause and effect," he says.

    A recent global health report revealed that oral diseases such as untreated tooth decay and gum disease affected 3.5 billion people in 2022, making them the most widespread health conditions in the world.

    [6] In the United States, about 4 in 10 adults have some form of periodontal (gum) disease, such as gingivitis and periodontitis. In adults over 65, 6 out every 10 people have gum disease.

    [7]

    Bottom Line: Flossing Is an Easy and Affordable Way to Improve Health

    "Flossing isn't just good for your teeth — it might help protect your heart and brain, too," says Sen.

    "It's a simple, affordable way to improve oral health and possibly prevent serious heart and brain conditions," he says.


    Could Flu, COVID, RSV Symptoms Actually Be A Heart Attack?

    STATEN ISLAND, N.Y. — During the recent surge in influenza, COVID-19, norovirus, respiratory syncytial virus (RSV) and other respiratory viruses, it's critical to pay close attention to your heart and symptoms, cardiology experts warn.

    "Some patients may think that symptoms such as being short of breath, weak, cold, or feverish, or having dizziness or chest pain may be solely a result of these winter viruses, but these symptoms could also be associated with, and masking, dangerous cardiovascular complications, such as heart attack, pulmonary embolism, viral myocarditis, pericarditis, or even heart failure,'' an announcement from Mount Sinai Fuster Heart Hospital stated.

    Some patients have been missing serious heart complication symptoms, thinking they have the flu, the doctors warned.

    "For example, some patients have shortness of breath, wheezing, coughing, swelling, and palpitations, and assume their symptoms are linked to a cold, when in fact they were actually in heart failure,'' said Dr. Johanna Contreras, a cardiologist at Mount Sinai Fuster Heart Hospital. "Other patients who have had persistent chest pain and palpitations after acute viral illness may need to consider that, in fact, this could be myocarditis."

    Don't ignore these symptoms, thinking they are just a long-lasting viral infection, especially if you're at high risk of heart disease, the doctor said.

    "Make sure to consult your doctor or call 911 if you have worsening chest pain, dizziness, or shortness of breath — a serious cardiac condition can progress quickly and it's key to catch complications early, before they become life-threatening,'' Contreras said.

    Inflammation can trigger heart attacks in people with coronary artery disease. It can also exacerbate heart failure symptoms and irregular or rapid heartbeats, leading to hospitalization, the hospital announcement said.

    "While the immune system's primary job is to eliminate the virus, the inflammatory response can inadvertently harm cardiac tissue,'' said Dr. Anuradha Lala, a cardiologist at Mount Sinai Fuster Heart Hospital. "Thus, if you have a known heart condition, viral infections can bring on exacerbations — or a worsening of the underlying issue — whether it is atrial fibrillation, coronary heart disease, or heart failure."

    Doctors have seen post-viral myocarditis — inflammation around the heart that can progress to complications such as heart failure and cardiogenic shock — in otherwise healthy patients, a hospital announcement said.

    "In fact, anyone is susceptible, even health-care providers themselves are susceptible, and anyone who is not paying attention to their symptoms may get sick with potentially life-threatening complications," said Dr. Icilma Fergus, director of cardiovascular disparities for the Mount Sinai Health System.

    It is often difficult to differentiate between viral symptoms and symptoms of a heart attack, doctors report, Fergus said.

    "A recent patient had severe shortness of breath, weakness, palpitations and fatigue, fearing they had heart failure,'' the doctor said. "After the patient had bloodwork taken, there was a frantic moment when we could not reach them to share results that revealed a significantly elevated troponin level, which can be linked to a heart attack. Although we suspected the worst, we eventually reached the patient, and they were hospitalized with Influenza A and severe viral myocarditis. They were treated appropriately, and luckily there was a good outcome."

    Heart disease

    Heart disease is the leading cause of death for men, women and people of most racial and ethnic groups, according to the Centers for Disease Control and Prevention.

    One person in the United States dies of cardiovascular disease every 33 seconds, more than 700,000 people die of heart disease annually and 80% of these cases are preventable.

    Anyone can get heart disease, but people are more susceptible if they have cardiovascular risk factors such as high cholesterol, high blood pressure, diabetes, are overweight or use tobacco.

    Age is also a factor, specifically for menopausal women (between 45 and 55) and men older than 55.

    Certain groups, including African American and Hispanic/Latino people as well as new immigrants, may also be at higher risk of complications from untreated viral illnesses. However, risk for cardiovascular disease in any population can be decreased by taking simple steps toward a healthier lifestyle.

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