Atherosclerotic coronary artery disease (CAD) occurs in direct association with accumulation of extracellular matrix molecules in the vascular wall, including the basement membrane protein collagen type IV. Perivascular matrix accumulation is also a hallmark of gingival changes associated with periodontal disease. Although an association between atherosclerosis and thickened vascular walls in the gingiva has been made, there has been no report on the biochemical nature of the association. In one aim of this project, we will test the hypothesis that the underlying mechanisms associated with the development of atherosclerotic processes and periodontitis are linked through the changes to the blood vessel walls, particularly the accumulation of collagen type IV. Our preliminary data, based on verbal history of CAD reported by participants in interview, supports this aim. An important objective of this proposed project is to extend and validate these preliminary data by collaborating with the new NSU Vascular Sonography Program in the use of high resolution ultrasound to more accurately and sensitively measure atherosclerotic development in our participants. Interestingly, periodontal pathogens have been identified in carotid atherosclerotic lesions, and animal models indicate that certain periodontal pathogens can accelerate atherosclerosis. Therefore, in a separate specific aim, we will also test the hypothesis that serum antibodies against a known oral pathogen associated with both periodontitis and atherosclerosis will demonstrate an inverse, or protective, statistical relationship with atherosclerotic development in our participants. Together, these cross-sectional data may support evidence for a common mechanism in ischemic diseases such as atherosclerotic CAD and periodontal disease, may offer the potential for valuable adjuncts in their early-stage prediction, and may help establish a role for immunotherapy in their control.