The Role of Exposure to Per- and Polyfluoroalkyl Substances in Racial/Ethnic Disparities in Hypertension: Results from the Study of Women’s Health Across the Nation

Details

• Alternative Title:
  Environ Res
• Personal Author:
  Ding, Ning ; Karvonen-Gutierrez, Carrie A. ; Zota, Ami R. ; Mukherjee, Bhramar ; Harlow, Siobán D. ; Park, Sung Kyun
• Description:
  Background:
  
  Racial/ethnic disparities in hypertension are a pressing public health problem. The contribution of environmental pollutants including PFAS have not been explored, even though certain PFAS are higher in Black population and have been associated with hypertension.
  
  Objectives:
  
  We examined the extent to which racial/ethnic disparities in incident hypertension are explained by racial/ethnic differences in serum PFAS concentrations.
  
  Methods:
  
  We included 1,058 hypertension-free midlife women with serum PFAS concentrations in 1999–2000 from the multi-racial/ethnic Study of Women’s Health Across the Nation with approximately annual follow-up visits through 2017. Causal mediation analysis was conducted using accelerated failure time models. Quantile-based g-computation was used to evaluate the joint effects of PFAS mixtures.
  
  Results:
  
  During 11,722 person-years of follow-up, 470 participants developed incident hypertension (40.1 cases per 1000 person-years). Black participants had higher risks of developing hypertension (relative survival: 0.58, 95% CI: 0.45–0.76) compared with White participants, which suggests racial/ethnic disparities in the timing of hypertension onset. The percent of this difference in timing that was mediated by PFAS was 8.2% (95% CI: 0.7–15.3) for PFOS, 6.9% (95% CI: 0.2–13.8) for EtFOSAA, 12.7% (95% CI: 1.4–22.6) for MeFOSAA, and 19.1% (95% CI: 4.2, 29.0) for PFAS mixtures. The percentage of the disparities in hypertension between Black versus White women that could have been eliminated if everyone’s PFAS concentrations were dropped to the 10th percentiles observed in this population was 10.2% (95% CI: 0.9–18.6) for PFOS, 7.5% (95% CI: 0.2–14.9) for EtFOSAA, and 17.5% (95% CI: 2.1–29.8) for MeFOSAA.
  
  Conclusions:
  
  These findings suggest differences in PFAS exposure may be an unrecognized modifiable risk factor that partially accounts for racial/ethnic disparities in timing of hypertension onset among midlife women. The study calls for public policies aimed at reducing PFAS exposures that could contribute to reductions in racial/ethnic disparities in hypertension.
  
  
• Subjects:
  Environmental Pollutants Female Fluorocarbons/toxicity Humans Hypertension Racial Groups Women's Health
• Source:
  Environ Res. 227:115813
• Pubmed ID:
  37004857
• Pubmed Central ID:
  PMC10227830
• Document Type:
  Journal Article
• Funding:
  T42 OH008455/OH/NIOSH CDC HHSUnited States/ ; U01 AG012554/AG/NIA NIH HHSUnited States/ ; R01 ES031065/ES/NIEHS NIH HHSUnited States/ ; P30 ES017885/ES/NIEHS NIH HHSUnited States/ ; U01 AG012495/AG/NIA NIH HHSUnited States/ ; U01 AG012505/AG/NIA NIH HHSUnited States/ ; U01 AG012535/AG/NIA NIH HHSUnited States/ ; U01 AG012553/AG/NIA NIH HHSUnited States/ ; U01 NR004061/NR/NINR NIH HHSUnited States/ ; U01 AG012539/AG/NIA NIH HHSUnited States/ ; R01 ES026578/ES/NIEHS NIH HHSUnited States/ ; U01 AG012546/AG/NIA NIH HHSUnited States/ ; U01 AG012531/AG/NIA NIH HHSUnited States/ ; R01 ES026964/ES/NIEHS NIH HHSUnited States/ ; U01 AG017719/AG/NIA NIH HHSUnited States/
• Volume:
  227
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:789a32a4f7c30a088e8c727bee99d3489f7bd21f9cec1d55810a47bcbae4a49a
• Download URL:
  https://stacks.cdc.gov/view/cdc/129373/cdc_129373_DS1.pdf
• File Type:
  [PDF - 666.71 KB ]