Increased exposure to per- and polyfluoroalkyl substances (PFAS), or “permanent chemicals,” has been associated with an increased risk of incident hypertension in women.
An analysis of data from the Nationwide Women’s Health Study – Multi-Pollutant Study (SWAN-MPS), study results indicate that women have the third highest concentrations of perfluorooctane acid sulfonic acid (n-PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamido)acetic acid (EtFOSAA) had a 42%, 47%, and 42% higher risk of developing hypertension, respectively, compared to compared to women in the lowest concentrations of one-third of these PFAS.
“Women appear to be particularly vulnerable when exposed to these chemicals,” said lead researcher Ning Ding, PhD, MPH, postdoctoral fellow in the Department of Epidemiology at the University of Michigan School of Public Health. in Ann Arbor, Michigan, in a statement from the American Heart Association. “Our study is the first to examine the association between ‘permanent chemicals’ and hypertension in middle-aged women. Exposure may be an underestimated risk factor for cardiovascular disease risk in women.
An extension of the multi-site, multi-racial, multi-ethnic, community-based longitudinal SWAN study, SWAN-MPS was initiated in 2006 with the aim of examining the long-term health effects of several pollutants in women aged Wall. Of over 1600 women included in SWAN-MPS, 1058 middle-aged women with no history of hypertension with annual follow-up visits from 1999 to 2017 were identified for inclusion in the current study. For analysis, Cox proportional hazards models were used to calculate hazard ratios and quartile g calculation was used to assess the joint effect of PFAS mixtures.
A total of 7 different PFAS were identified for inclusion in investigator analyses. These included perfluorohexane sulfonate (PFHxS), linear perfluorooctane sulfonate (n-PFOS), sum of branched isomers of PFOS (Sm-PFOS), linear perfluorooctanoate (n-PFOA), sum of branched PFOA , perfluorononanoate, perfluorodecanoate, perfluoroundecanoate, perfluorododecanoate, EtFOSAA and 2-(N-methyl-perfluorooctane sulfonamido)acetate (MeFOSAA). The concentrations of each were determined by the use of solid phase extraction-high performance liquid chromatography-isotopic dilution-tandem mass spectrometry.
From this cohort, investigators obtained data for 11,722 person-years of follow-up. During this period, 470 women developed incident hypertension, corresponding to 40.1 cases per 1000 person-years. Compared to those in the lowest tertile of serum concentrations, an increased risk of hypertension was observed in women in the highest tertile of PFOS (HR, 1.42 [95% CI, 1.19–1.68]; P=.01), for PFOA (RH, 1.47 [95% CI, 1.24–1.75]; P=.01), and for EtFOSAA (HR, 1.42 [95% CI, 1.19–1.70]; P=.01).
The investigators pointed out that there was no significant association observed for perfluorononanoate and perfluorohexane sulfonate. Further analysis suggested that people in the highest tertile of overall PFAS concentrations had an increased risk of incident hypertension (HR, 1.71 [95% CI, 1.15–2.54]; P= 0.008) relative to those in the lowest tertile of overall PFAS concentrations.
“Importantly, we looked at individual PFASs as well as multiple PFASs together, and found that combined exposure to multiple PFASs had a stronger effect on blood pressure,” said lead researcher Sung Kyun Park. , ScD, MPH, Associate Professor. of Epidemiology and Environmental Health Sciences at the University of Michigan School of Public Health, in the aforementioned statement. “Some states are beginning to ban the use of PFAS in food packaging and cosmetic and personal care products. Our results clearly indicate that strategies to limit the widespread use of PFAS in products need to be developed. alternative options may help reduce the incidence of high blood pressure risk in middle-aged women.
This study, “Per- and Polyfluoroalkyl Substances and Incident Hypertension in Multi-Racial/Ethnic Women: The Study of Women’s Health Across the Nation,” was published in Hypertension.