How cosmetics, food packaging chemicals raise BP risk

A recent study has described how “forever chemicals” used in everyday household items such as certain shampoo, dental floss, cosmetics, non-stick cookware, food packaging, stain-resistant coatings for carpeting, upholstery and clothing raise the risk of developing hypertension.

According to new research published yesterday in Hypertension, an American Heart Association journal, middle-aged women with higher blood concentrations of common synthetic chemicals called per- and polyfluoroalkyl substances (PFAS), also called “forever chemicals” and found in water, soil, air and food, were at greater risk of developing high blood pressure, compared to their peers who had lower levels of these substances.

PFAS, are a class of synthetic chemicals and according to the United States (U.S.) Environmental Protection Agency, there are thousands of different PFAS. The “forever chemicals” also enter the food system through fish caught in PFAS-contaminated water and dairy products from cows exposed to PFAS through fertilizers on farms, for example.

Even at low levels in the blood, research has shown PFAS can have detrimental health effects. Some PFAS have been linked to cardiovascular risk, including endothelial dysfunction (impaired blood vessel function), oxidative stress and elevated cholesterol. However, no previous studies have evaluated whether PFAS levels affect blood pressure control among middle-aged women.

Previously published data from the National Health and Nutrition Examination Survey (NHANES) demonstrates how common PFAS exposure is, as nearly all Americans have detectable concentrations of at least one PFAS in their blood.

Study lead author and a post-doctoral fellow in the department of epidemiology at the University of Michigan School of Public Health in Ann Arbor, Michigan, Dr. Ning Ding, said: “PFAS are known as ‘forever chemicals’ because they never degrade in the environment and contaminate drinking water, soil, air, food and numerous products we consume or encounter routinely. One study estimated that two of the most common ’forever chemicals’ are found in most household drinking water and are consumed by more than two-thirds of Americans.

“Women seem to be particularly vulnerable when exposed to these chemicals,” she said. “Our study is the first to examine the association between ‘forever chemicals’ and hypertension in middle-aged women. Exposure may be an underappreciated risk factor for women’s cardiovascular disease risk.”

Using data from the Study of Women’s Health Across the Nation-Multi-Pollutant Study (SWAN-MPS), a prospective study of women from diverse racial and ethnic backgrounds at midlife, researchers examined blood concentrations of specific PFAS and the risk of high blood pressure. Data included more than 1,000 women, 45-56-years old who had normal blood pressure when they enrolled in the study. Blood concentrations of PFAS were measured at the start of the study.

All participants were followed almost yearly from 1999-2017. Participants were recruited from five institutional sites (Boston; Pittsburgh; Southeast Michigan; Los Angeles; and Oakland, California) across the U.S., and they self-identified as Black (15.2 per cent), Chinese (14.1 per cent), Japanese (16.2 per cent) or white women (54.5 per cent). All sites enrolled non-Hispanic white women in addition to one additional racial/ethnic group.

The analysis found:
•During 11,722 person-years of follow-up for all study participants, 470 women developed high blood pressure.
•Women with higher concentrations of specific PFAS were more likely to develop high blood pressure: women in the highest one-third concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid (EtFOSAA, a PFOS precursor) had 42 per cent, 47 per cent and 42 per cent higher risks, respectively, of developing high blood pressure, compared to women in the lowest one-third concentrations of these PFAS.
•Women in the highest one-third concentrations of all seven PFAS examined had a 71 per cent increased risk of developing high blood pressure.

Study senior author and associate professor of epidemiology and environmental health sciences at the University of Michigan School of Public Health, Dr. Sung Kyun Park, said: “It’s important to note that we examined individual PFAS as well as several PFAS together, and we found that the combined exposure to multiple PFAS had a stronger effect on blood pressure.

“Some states are beginning to ban the use of PFAS in food packaging and cosmetic and personal care products. Our findings make it clear that strategies to limit the widespread use of PFAS in products need to be developed. Switching to alternative options may help reduce the incidence of high blood pressure risk in midlife women.

“We have known for some time that PFAS disrupt metabolism in the body, yet, we didn’t expect the strength of the association we found. We hope that these findings alert clinicians about the importance of PFAS and that they need to understand and recognise PFAS as an important potential risk factor for blood pressure control.”