Much of the public health spotlight on endocrine-disrupting chemicals has rested on bisphenol A and its safety, but exposure to another common chemical found in surfactants, lubricants, polishes, paper and textile coatings, food packaging and fire-retardant foams was found to increase risk for cardiovascular disease and peripheral arterial disease.
Previous studies have found that exposure to perfluorooctanoic acid (PFOA) has been linked to increased cholesterol levels, and higher levels of PFOA have been linked to insulin resistance and metabolic syndrome among adolescents and adults, the researchers wrote. Yet, associations between PFOA and CVD have not been studied.
“Cardiovascular disease is the leading cause of death in the United States. Approximately 70% of CVD can be attributed to modifiable, nongenetic factors, and classic risk factors, such as smoking status and obesity, among others, do not account for all the observed CVD risk in the general population,” researchers wrote.
Using the National Health and Nutrition Examination Survey (1999-2003), researchers examined 1,216 patients (51.2% women). Serum PFOA levels were investigated in quartiles based on sex differences in PFOA levels in previous studies.
The main outcomes were self-reported CVD, including coronary heart disease, stroke and peripheral arterial disease (PAD), which was identified as an ankle-brachial blood pressure index of less than 0.9, researchers wrote.
According to results, patients with higher PFOA levels were more likely to be young, non-Hispanic white, who were considered to be heavy drinkers. These patients were also more likely to have education beyond high school, have hypertension, high total cholesterol, and less likely to be non-Hispanic black or Mexican American.
The researchers found that increasing PFOA levels were associated with CVD and PAD, independent of various confounders (ie, age, sex, race, smoking status, BMI, diabetes, hypertension and serum cholesterol levels). When compared with quartile 1 of PFOA levels, the multivariable OR in quartile 4 was 2.01 (95% CI, 1.12-3.60) for CVD. And for PAD, the OR was 1.78 (95% CI, 1.03-3.08), according to data.
Due to the cross-sectional nature of the study, researchers wrote that they could not conclude the associations were causal. However, “Owing to the pervasive presence of PFOA, its public health effects are a concern,” they wrote.
The researchers said further prospective studies are needed to confirm or disprove these findings.
Disclosure: The researchers report no relevant financial disclosures.