Per- and Polyfluoroalkyl Substances and Incident Hypertension in Multi-Racial/Ethnic Women: The Study of Women's Health Across the Nation

Ding, Ning; Karvonen‐Gutierrez, Carrie; Mukherjee, Bhramar; Calafat, Antònia M.; Harlow, Sioḃán D.; Park, Sung Kyun

doi:10.1161/hypertensionaha.121.18809

Cited by 33 publications

(28 citation statements)

References 73 publications

(119 reference statements)

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“…Immune system (a) Reduced formation of vaccine antibodies [182,183,191,192,485,486] (b) Autoimmune diseases: Colitis ulcerosa [487] 10. Heart, circulatory system Cardiovascular issues [488][489][490][491][492] Hypertension [410,488,493,494] 11. Genetics: epigenetic PFAS-effects can be transferred to following generations [455,[495][496][497][498][499] 12.…”

Section: Affected Organ/function Consequencesmentioning

confidence: 99%

PFAS: forever chemicals—persistent, bioaccumulative and mobile. Reviewing the status and the need for their phase out and remediation of contaminated sites

Brunn

Arnold²,

Körner

et al. 2023

Environ Sci Eur

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Background Per- and polyfluorinated alkyl substances (PFAS) have received increasing scientific and political attention in recent years. Several thousand commercially produced compounds are used in numerous products and technical processes. Due to their extreme persistence in the environment, humans and all other life forms are, therefore, increasingly exposed to these substances. In the following review, PFAS will be examined comprehensively. Results The best studied PFAS are carboxylic and sulfonic acids with chain lengths of C4 to C14, particularly perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS). These substances are harmful to aquatic fauna, insects, and amphibians at concentrations of a few µg/L or less, accumulate in organisms, and biomagnify in food webs. Humans, as the final link in numerous food chains, are subjected to PFAS uptake primarily through food and drinking water. Several PFAS have multiple toxic effects, particularly affecting liver, kidney, thyroid, and the immune system. The latter effect is the basis for the establishment of a tolerable weekly dose of only 4.4 ng/kg body weight for the sum of the four representatives PFOA, PFOS, perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) by the European Food Safety Authority (EFSA) in 2020. Exposure estimates and human biomonitoring show that this value is frequently reached, and in many cases exceeded. PFAS are a major challenge for analysis, especially of products and waste: single-substance analyses capture only a fragment of the large, diverse family of PFAS. As a consequence, sum parameters have gained increasing importance. The high mobility of per and polyfluorinated carboxylic and sulfonic acids makes soil and groundwater pollution at contaminated sites a problem. In general, short-chain PFAS are more mobile than long-chain ones. Processes for soil and groundwater purification and drinking water treatment are often ineffective and expensive. Recycling of PFAS-containing products such as paper and food packaging leads to carryover of the contaminants. Incineration requires high temperatures to completely destroy PFAS. After PFOA, PFOS and a few other perfluorinated carboxylic and sulfonic acids were regulated internationally, many manufacturers and users switched to other PFAS: short-chain representatives, per- and polyfluorinated oxo carboxylic acids, telomeric alcohols and acids. Analytical studies show an increase in environmental concentrations of these chemicals. Ultra-short PFAS (chain length C1–C3) have not been well studied. Among others, trifluoroacetic acid (TFA) is present globally in rapidly increasing concentrations. Conclusions The substitution of individual PFAS recognized as hazardous by other possibly equally hazardous PFAS with virtually unknown chronic toxicity can, therefore, not be a solution. The only answer is a switch to fluorine-free alternatives for all applications in which PFAS are not essential.

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Section: Affected Organ/function Consequencesmentioning

confidence: 99%

PFAS: forever chemicals—persistent, bioaccumulative and mobile. Reviewing the status and the need for their phase out and remediation of contaminated sites

Brunn

Arnold²,

Körner

et al. 2023

Environ Sci Eur

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“…Analysis of participants in the SWAN study (females only, United States, 1281 participants) showed that both PFOA and PFOS were strongly associated with increased risk of hypertension. 88 In contrast, studies of populations with both genders and larger age ranges did not show longitudinal associations between PFAS body burden and the risk of hypertension. Participants in the DPP study (United States, 957 participants) showed null associations between PFOA, PFNA, PFHxS, or PFOS with the risk of hypertension.…”

Section: Pfas and Cvd Risk Factorsmentioning

confidence: 93%

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Schlezinger,

Gokce

2024

Circulation Research

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Conservative estimates by the World Health Organization suggest that at least a quarter of global cardiovascular diseases are attributable to environmental exposures. Associations between air pollution and cardiovascular risk have garnered the most headlines and are strong, but less attention has been paid to other omnipresent toxicants in our ecosystem. Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are man-made chemicals that are extensively used in industrial and consumer products worldwide and in aqueous film-forming foam utilized in firefighting. As such, our exposure to PFAS is essentially ubiquitous. Given the long half-lives of these degradation-resistant chemicals, virtually, all people are carrying a body burden of PFAS. Health concerns related to PFAS are growing such that the National Academies of Sciences, Engineering and Medicine has recommended standards for clinical follow-up of individuals with high PFAS blood levels, including prioritizing screening for dyslipidemia. The link between PFAS and dyslipidemia has been extensively investigated, and evidence for associations is compelling. However, dyslipidemia is not the only cardiovascular risk factor with which PFAS is associated. Here, we review the epidemiological evidence for links between PFAS of concern identified by the National Academies of Sciences, Engineering and Medicine and risk factors for cardiovascular disease, including overweight/obesity, glucose intolerance, hypertension, dyslipidemia, and hyperuricemia. Moreover, we review the potential connections of PFAS with vascular disease and atherosclerosis. While observational data support associations between the National Academies of Sciences, Engineering and Medicine PFAS and selected cardiac risk factors, additional research is needed to establish causation and better understand how exposure to PFAS leads to the development of these conditions.

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“…90,91 Data from the National Health and Nutrition Examination Survey demonstrate the ubiquity of per- and polyfluoroalkyl substance exposure. 92 Due to their structural similarity to fatty acids, per- and polyfluoroalkyl substances may interfere with the action of peroxisome proliferator-activated receptors and their signaling pathways. Recent evidence suggests strong evidence linking a variety of per- and polyfluoroalkyl substances with cardiovascular outcomes, including hypertension.…”

Section: Urban Provisioning Systems and Exposures Affecting Human Healthmentioning

confidence: 99%

“…Recent evidence suggests strong evidence linking a variety of per- and polyfluoroalkyl substances with cardiovascular outcomes, including hypertension. 92 Most urban water management systems in the United States do not purify chemicals and metals and, thus, these concerns demand the transformation of urban water systems from source to use.…”

Section: Urban Provisioning Systems and Exposures Affecting Human Healthmentioning

confidence: 99%

The Urban Environment and Cardiometabolic Health

Rajagopalan,

Vergara-Martel,

Zhong

et al. 2024

Circulation

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Urban environments contribute substantially to the rising burden of cardiometabolic diseases worldwide. Cities are complex adaptive systems that continually exchange resources, shaping exposures relevant to human health such as air pollution, noise, and chemical exposures. In addition, urban infrastructure and provisioning systems influence multiple domains of health risk, including behaviors, psychological stress, pollution, and nutrition through various pathways (eg, physical inactivity, air pollution, noise, heat stress, food systems, the availability of green space, and contaminant exposures). Beyond cardiometabolic health, city design may also affect climate change through energy and material consumption that share many of the same drivers with cardiometabolic diseases. Integrated spatial planning focusing on developing sustainable compact cities could simultaneously create heart-healthy and environmentally healthy city designs. This article reviews current evidence on the associations between the urban exposome (totality of exposures a person experiences, including environmental, occupational, lifestyle, social, and psychological factors) and cardiometabolic diseases within a systems science framework, and examines urban planning principles (eg, connectivity, density, diversity of land use, destination accessibility, and distance to transit). We highlight critical knowledge gaps regarding built-environment feature thresholds for optimizing cardiometabolic health outcomes. Last, we discuss emerging models and metrics to align urban development with the dual goals of mitigating cardiometabolic diseases while reducing climate change through cross-sector collaboration, governance, and community engagement. This review demonstrates that cities represent crucial settings for implementing policies and interventions to simultaneously tackle the global epidemics of cardiovascular disease and climate change.

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Per- and Polyfluoroalkyl Substances and Incident Hypertension in Multi-Racial/Ethnic Women: The Study of Women's Health Across the Nation

Cited by 33 publications

References 73 publications

PFAS: forever chemicals—persistent, bioaccumulative and mobile. Reviewing the status and the need for their phase out and remediation of contaminated sites

PFAS: forever chemicals—persistent, bioaccumulative and mobile. Reviewing the status and the need for their phase out and remediation of contaminated sites

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

The Urban Environment and Cardiometabolic Health

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