Association between perfluoroalkyl acids and the prevalence of hypertension among US adults

Liao, Shengen; Yao, Wenming; Cheang, Iokfai; Tang, Xiaosu; Yin, Ting; Lu, Xinyi; Zhou, Yanli; Zhang, Haifeng; Li, Xinli

doi:10.1016/j.ecoenv.2020.110589

Cited by 40 publications

(35 citation statements)

References 26 publications

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“…In contrast, He et al (n = 7543) reported no signi cant association with blood pressure, but blood pressure was not the primary outcome of this study [19]. In a recent cross-sectional study on 6967 adults from NHANES, Liao et al found a positive log-linear association of serum PFOA, PFOS, and PFHxS with SBP and a non-linear J-shaped association of serum PFOS and PFNA with DBP; moreover, the study showed a non-linear J-shaped association of serum PFOA and PFNA with the odds of hypertension [14]. The other two studies focused on children and adolescents with background exposure to PFAS [11,18], yielding con icting results: while Geiger et al (n = 1655) found no evidence of an association between serum PFAS and blood pressure or hypertension [18], Ma et al (n = 2251) found a positive signi cant association between PFOS and DBP among males [11].…”

Section: Discussionmentioning

confidence: 58%

“…Literature on the association between PFAS exposure and blood pressure and/or hypertension (de ned as self-reported diagnosis or treatment or elevated measured blood pressure) is relatively limited, with contradictory ndings. Some large cross-sectional studies were conducted on representative samples of the US general population with background exposure using data from the NHANES survey [11,12,14,18,19]. Among 2934 adults, Min et al showed a signi cant increase in SBP, but not DBP, associated with increasing PFOA concentrations [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, these ndings were not demonstrated in other cross sectional studies [15][16][17][18][19][20], nor in two longitudinal studies on hypertension [21] and one on blood pressure trajectory [22]. The association of serum PFAS with blood pressure as a continuous outcome was evaluated in few cross-sectional studies, but with con icting ndings [9,11,12,14].…”

Section: Introductionmentioning

confidence: 94%

“…High blood pressure is one of the most prevalent conditions increasing the risk of cardiovascular events [8]. Several studies in the general population [9][10][11][12][13][14], and just one on 500 highly exposed individuals in China [9] found positive associations between serum PFAS concentrations and hypertension. However, these ndings were not demonstrated in other cross sectional studies [15][16][17][18][19][20], nor in two longitudinal studies on hypertension [21] and one on blood pressure trajectory [22].…”

Section: Introductionmentioning

confidence: 99%

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Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

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Jeddi

Barbieri

et al. 2020

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BackgroundResidents in a large area of North-Eastern Italy were exposed to perfluoroalkyl substances (PFAS) via drinking water. Studies on the association between PFAS and blood pressure levels are limited, and results are inconsistent. Using cross-sectional data from the Regional health surveillance program, we aimed to quantify the associations between PFAS serum concentrations and blood pressure and hypertension prevalence.MethodsThe study comprised 16,224 individuals aged 20-39 years. Pregnant women (n=327), or individuals with missing information on the selected covariates (n=111) were excluded, leaving 15,786 subjects for the analyses. Hypertension was defined as any self-reported diagnosis, use of antihypertensive drugs, or elevated systolic blood pressure (SBP≥140 mmHg)/diastolic blood pressure (DBP≥90 mmHg). Generalized additive models were used to investigate the relation between perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)) natural log (ln) transformed and by decile, and SBP, DBP, hypertension, adjusted for potential confounders.ResultsBoth SBP and DBP increased significantly with an increase in the ln-transformed serum PFAS concentrations in a monotonic way. The predicted increase in SBP and DBP were 1.54 mmHg (95%CI 0.61-2.47), 1.60 mmHg (95%CI 0.92-2.27) from lowest to highest decile of PFOA. The associations were stronger for SBP in men and for DBP in women. One unit increase in each In-transformed PFAS was positively associated with an increased odd of hypertension in men: PFOA OR=1.06 (1.01-1.11), PFOS OR=1.13 (1.03-1.23), PFHxS OR=1.08 (1.02-1.15), PFNA OR=1.20 (1.02-1.40).ConclusionsOur findings suggest that serum PFAS concentrations were associated with increased systolic and diastolic blood pressure in a large highly exposed young adult population. Although the magnitude of the observed effect was relatively small, if confirmed it would be of public health relevance since even small increases in blood pressure levels at the population level may be associated to a raised risk of adverse outcomes such as cardiovascular disease and target organ damage.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

Pitter

Jeddi

Barbieri

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…High blood pressure is one of the most prevalent conditions increasing the risk of cardiovascular events [8]. Several studies in the general population [9][10][11][12][13][14], and just one on 500 highly exposed individuals in China [9] found positive associations between serum PFAS concentrations and hypertension. However, these findings were not demonstrated in other cross sectional studies [15][16][17][18][19][20], nor in two longitudinal studies on hypertension [21] and one on blood pressure trajectory [22].…”

Section: Introductionmentioning

confidence: 99%

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

et al. 2020

View full text Add to dashboard Cite

Background Residents in a large area of North-Eastern Italy were exposed to perfluoroalkyl substances (PFAS) via drinking water. Studies on the association between PFAS and blood pressure levels are limited, and results are inconsistent. Using cross-sectional data from the Regional health surveillance program, we aimed to quantify the associations between PFAS serum concentrations and blood pressure and hypertension prevalence. Methods The study comprised 16,224 individuals aged 20–39 years. Pregnant women (n = 327), or individuals with missing information on the selected covariates (n = 111) were excluded, leaving 15,786 subjects for the analyses. Hypertension was defined as any self-reported diagnosis, use of antihypertensive drugs, or elevated systolic blood pressure (SBP ≥ 140 mmHg)/diastolic blood pressure (DBP ≥ 90 mmHg). Generalized additive models were used to investigate the relation between perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)) natural log (ln) transformed and by decile, and SBP, DBP, hypertension, adjusted for potential confounders. Results Both SBP and DBP increased significantly with an increase in the ln-transformed serum PFAS concentrations in a monotonic way. The predicted increase in SBP and DBP were 1.54 mmHg (95%CI 0.61–2.47), 1.60 mmHg (95%CI 0.92–2.27) from lowest to highest decile of PFOA. The associations were stronger for SBP in men and for DBP in women. One unit increase in each In-transformed PFAS was positively associated with an increased odd of hypertension in men: PFOA OR = 1.06 (1.01–1.11), PFOS OR = 1.13 (1.03–1.23), PFHxS OR = 1.08 (1.02–1.15), PFNA OR = 1.20 (1.02–1.40). Conclusions Our findings suggest that serum PFAS concentrations were associated with increased systolic and diastolic blood pressure in a large highly exposed young adult population. Although the magnitude of the observed effect was relatively small, if confirmed it would be of public health relevance since even small increases in blood pressure levels at the population level may be associated to a raised risk of adverse outcomes such as cardiovascular disease and target organ damage.

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A review of cardiovascular effects and underlying mechanisms of legacy and emerging per- and polyfluoroalkyl substances (PFAS)

et al. 2023

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Association between perfluoroalkyl acids and the prevalence of hypertension among US adults

Cited by 40 publications

References 26 publications

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

Perfluoroalkyl substances are associated with elevated blood pressure and hypertension in highly exposed young adults

A review of cardiovascular effects and underlying mechanisms of legacy and emerging per- and polyfluoroalkyl substances (PFAS)

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