Women, Toxic PFAS Forever Chemicals and Hypertension

According to new scientific research, middle-aged women with higher blood concentrations of toxic PFAS chemicals (per- and polyfluoroalkyl substances) commonly found in drinking water, soil, air, products and food*, are at greater risk of developing high blood pressure**, compared to their peers who have lower levels of PFAS chemicals in their bodies.***

Study overview

Using data from the 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 annually from 1999-2017. During this time, 470 women developed high blood pressure.

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%), Chinese (14.1%), Japanese (16.2%) or white females (54.5%). All sites enrolled non-Hispanic white women in addition to one additional racial/ethnic group.

Results overview

Several PFAS chemicals showed positive associations with incident hypertension. These findings suggest that PFAS might be an underappreciated contributing factor to women’s cardiovascular disease risk.

The study results indicated that the combined exposure to multiple PFAS had a stronger effect on blood pressure.  More specifically, women aged 45 to 56 who had the highest concentrations of seven PFAS chemicals were 71% more likely to develop high blood pressure than women with the lowest levels of PFAS.

In addition to the heightened high blood pressure risk seen with a combination of seven PFAS chemicals, women with higher concentrations of three specific PFAS were also more likely to develop high blood pressure.

Specifically, women with the highest concentrations of perfluorooctane sulfonic acid (PFOS) or acetic acid (EtFOSAA, a PFOS precursor) were 42% more likely to develop high blood pressure, and those with elevated perfluorooctanoic acid (PFOA) had a 47% increased risk for high blood pressure, compared to women who had the lowest concentrations of these chemicals.

“Women seem to be particularly vulnerable when exposed to these chemicals. 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.”

-Ning Ding, Ph.D., M.P.H., lead study author and post-doctoral fellow, department of epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan

What can you do?

The American Heart Association provides tips on how to control your blood pressure.

*PFAS are a ubiquitous class of commonly used synthetic chemicals that do not degrade or break down in the environment or human/animal bodies over time, hence the name “forever” chemicals.  According to the U.S. Environmental Protection Agency, there are thousands of different PFAS that are used in everyday household items, such as certain shampoo, dental floss, cosmetics, non-stick cookware, food packaging and stain-resistant coatings for carpeting, upholstery and clothing, to name a few.

**Research has shown PFAS can have detrimental health effects–even at low levels in the blood. Some PFAS have been linked to cardiovascular risk, including endothelial dysfunction (impaired blood vessel function), oxidative stress and elevated cholesterol.

***Nearly all Americans have detectable concentrations of at least one PFAS chemical in their blood.

Journal reference: Ning Ding, Carrie A. Karvonen-Gutierrez, Bhramar Mukherjee, Antonia M. Calafat, Siobán D. Harlow & Sung Kyun Park. Per- and Polyfluoroalkyl Substances and Incident Hypertension in Multi-Racial/Ethnic Women: The Study of Women’s Health Across the Nation, Hypertension Journal, an American Heart Association journal, 2022;0:10.1161/HYPERTENSIONAHA.121.18809.  Originally published 13 Jun 2022.  PDF of study abstract.