Called "forever chemicals" because they linger in the environment, new research suggests that middle-aged women with high levels of perfluoroalkyls and polyfluoroalkyls (PFAS) in their blood may be more vulnerable to high blood pressure.
In the study, women aged 45 to 56 who had the highest concentrations of seven of these chemicals were 71% more likely to develop high blood pressure than women with the lowest levels of PFAS.
"Obesity, stress and smoking are well-known risk factors for high blood pressure, and PFAS may be as important as or even more important than these factors because PFAS are widespread, and almost all people are exposed to PFAS," said study author Sung Kyun Park. He is an associate professor of epidemiology and environmental health sciences at the University of Michigan's School of Public Health.
PFAS can be found in water, soil, air and food. They are used in everyday household items, including shampoo, dental floss, cosmetics, nonstick cookware, food packaging, clothing and more.
This isn't the first study to suggest that PFAS can harm cardiovascular health. These chemicals have also been linked to heart disease risk and high cholesterol.
Exactly how they affect blood pressure levels isn't fully understood yet. But "PFAS are very similar to the building blocks of fats, so PFAS can disrupt the action of body's metabolism and blood pressure control," Park explained.
Exposure to PFAS can be reduced through policy changes that regulate PFAS discharge to waterways and the use of PFAS in consumer products, he said.
"The benefit of reducing the population exposure to PFAS and potential preventions of high blood pressure and other health conditions would be huge," Park noted.
For the study, Park and his colleagues looked at blood levels of seven specific PFAS in more than 1,000 middle-aged U.S. women who had normal blood pressure when the study began. Women were followed annually from 1999 to 2017. During this time, 470 women developed high blood pressure.
In addition to the heightened high blood pressure risk seen with a combination of seven PFAS, women with higher concentrations of three specific PFAS were also more likely to develop high blood pressure, the study showed.
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.
The study only included middle-aged women, and more research is needed to see if the findings apply to men, and women in other age groups, the authors said.
The findings were published June 13 in the journal Hypertension.
Dr. Nieca Goldberg is an American Heart Association spokesperson, the medical director of Atria New York City, and a clinical associate professor of medicine at New York University Grossman School of Medicine. She was not part of the study, but reviewed the findings.
Calling the research "thought-provoking because of how ubiquitous these chemicals are," Goldberg said that PFAS exposure should be considered in women who develop high blood pressure without other known risks such as high salt intake, family history or obesity.
"We have to think about alternatives to PFAS," Goldberg said. Nonstick cookware is convenient, but the coating on these pans can break down at high heat, she explained. "Even though it is harder to clean, stainless steel or ceramic cookware can help lower exposure."
You should also read the labels carefully when choosing personal care products and pick ones that are PFAS-free, she suggested.
High blood pressure can increase the risk for heart attack, stroke, kidney disease, eye disease and heart failure, Goldberg said. The best way to get ahead of these risks is to know your numbers.
"If you have high blood pressure, work with your doctor to lower it through lifestyle changes and/or medication," she recommended.
The American Heart Association provides tips on how to control your blood pressure.
SOURCES: Sung Kyun Park, ScD, MPH, associate professor, epidemiology and environmental health sciences, University of Michigan School of Public Health, Ann Arbor; Nieca Goldberg, MD, medical director, Atria New York City, and clinical associate professor, medicine, New York University; Hypertension, June 13, 2022