The “forever chemicals” known as per- and polyfluoroalkyl substances (PFAS) have been linked to an increased risk of high blood pressure among middle-aged women, following a large study from researchers in the United States.

The chemicals, a group of synthetic polymers first introduced in the 1930s, have thousands of different uses. They include nonstick cookware, cosmetics and shampoos, carpeting and upholstery, and types of clothing such as firefighting gear.

“Because of their widespread use and their persistence in the environment, many PFAS are found in the blood of people and animals all over the world and are present at low levels in a variety of food products and in the environment,” says the U.S. Environmental Protection Agency.

The public health impacts of chronic PFAS exposure have come under increasing scrutiny, with scientists at the University of Michigan School of Public Health now finding that middle-aged women in the group with the highest one-third concentrations of all seven investigated PFAS had a 71% increased risk of developing high blood pressure. Their findings were published this week in the journal Hypertension.

The results were based on data collected from 1,058 women of diverse racial and ethnic backgrounds, all between the ages of 45 and 56. They had normal blood pressures when they enrolled in the study and were followed from 1999 through 2017, with testing for PFAS at the five national locations participating in the research.

Overall, 470 women developed high blood pressure, defined as a systolic pressure of 140 mm Hg or higher, a diastolic pressure of 90 mm Hg or higher, or a person receiving antihypertensive treatment.

The women with higher concentrations of some specific PFAS chemicals, including perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), also were more likely to develop high blood pressure than those with lower levels, at 42% and 47% respectively.

While some PFAS chemicals have been linked to increased metabolic and cardiovascular risk, such as high cholesterol, the authors said this is the first study to establish the relationship between PFAS exposure and high blood pressure in middle-aged women.

“Women seem to be particularly vulnerable when exposed to these chemicals,” said lead author Dr. Ning Ding of the University of Michigan. “Exposure may be an underappreciated risk factor for women’s cardiovascular disease risk.”

Senior author Dr. Sung Kyun Park said the findings underscore the need to limit the widespread use of PFAS chemicals and turn to alternatives. More research, though, is needed to confirm the findings, evaluate impacts in men and other groups of people, and begin to find ways to reduce exposure.

“We have known for some time that PFAS disrupt metabolism in the body, yet we didn’t expect the strength of the association we found,” Park said. “We hope that these findings alert clinicians about the importance of PFAS and that they need to understand and recognize PFAS as an important potential risk factor for blood pressure control.”

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