Urinary phthalates are associated with higher blood pressure in childhood

Abstract

Objective: To examine associations of urinary phthalate levels with blood pressure (BP) and serum triglyceride and lipoprotein levels in children.

Study design: We performed a cross-sectional analysis of a subsample of US children aged 6-19 years who participated in the National Health and Nutrition Examination Survey between 2003 and 2008. We quantified exposure to 3 families of phthalates--low molecular weight, high molecular weight and di-2-ethylhexylphthalate (DEHP)--based on molar concentration of urinary metabolites. We assessed descriptive, bivariate, and multivariate associations with BP and lipid levels.

Results: Controlling for an array of sociodemographic and behavioral factors, as well as diet and body mass index, levels of metabolites of DEHP, a phthalate commonly found in processed foods, were associated with higher age-, sex-, and height-standardized BP. For each log unit (roughly 3-fold) increase in DEHP metabolites, a 0.041 SD unit increase in systolic BP z-score was identified (P = .047). Metabolites of low molecular weight phthalates commonly found in cosmetics and personal care products were not associated with BP. Phthalate metabolites were not associated with triglyceride levels, high-density lipoprotein level, or prehypertension.

Conclusions: Dietary phthalate exposure is associated with higher systolic BP in children and adolescents. Further work is needed to confirm these associations, as well as to evaluate opportunities for intervention.

Keywords: BMI; BP; Blood pressure; Body mass index; CDC; Centers for Disease Control and Prevention; DBP; DEHP; Di-2-ethylhexylphthalate; Diastolic BP; HDL; HMW; High molecular weight; High-density lipoprotein; LMW; Low molecular weight; MBP; MECPP; MEHHP; MEHP; MEOHP; MEP; Mono-(2-ethyl-5-carboxypentyl) phthalate; Mono-(2-ethyl-5-hydroxyhexyl) phthalate; Mono-(2-ethyl-5-oxohexyl) phthalate; Mono-(2-ethylhexyl) phthalate; Mono-ethyl phthalate; Mono-n-butyl-phthalate; NHANES; National Health and Nutrition Examination Survey; SBP; Systolic BP.