Phthalate exposure and high blood pressure in adults: a cross-sectional study in China

Environ Sci Pollut Res Int. 2018 Jun;25(16):15934-15942. doi: 10.1007/s11356-018-1845-1. Epub 2018 Mar 27.


Widespread phthalate exposure has been recently documented and is hypothesized to increase blood pressure (BP) in humans. However, current studies have provided inconclusive evidence for an association between phthalate exposure and BP. Human epidemiologic studies on the topic remain lacking. Therefore, this study aims to examine the association between serum phthalate concentrations and BP in a Chinese population. We measured several parameters of BP (systolic BP, diastolic BP, total cholesterol, and triglyceride) and the concentrations of 16 phthalates (dimethyl phthalate (DMP), diethyl phthalate, diisobutyl phthalate, dibutyl phthalate (DBP), bis (2-methoxyethyl) phthalate, bis (4-methyl-2-pentyl) phthalate, bis (2-ethoxyethyl) phthalate, diamyl phthalate, dihexyl phthalate, benzyl butyl phthalate, bis (2-nbutoxyethyl) phthalate (DBEP), dicyclohexyl phthalate, bis (2-ethyl hexyl) phthalate (DEHP), diisononyl phthalate, diphenyl phthalate, and di-n-octyl phthalate) in the serum of 474 adults recruited from a primary health care clinic. The relationship between serum phthalate concentrations and BP parameters was assessed with multivariate linear regressions. DBP was the most ubiquitous and dominant contaminant in the study population. The systolic BP of subjects in the median-exposure DEHP group significantly increased by 2.96 mmHg (p < 0.05) relative to that of subjects in the low-exposure group. Significant positive dose-related associations of DMP and DBEP with the levels of total cholesterol in serum (p for trend < 0.05) were also found. These associations persisted even when considering exposure to multiple phthalates. Our results suggested that phthalate exposure might increase BP in adults. However, our findings warrant further studies in a larger and more general population.

Keywords: Adult; Epidemiology; High blood pressure; Phthalate.

MeSH terms

  • China
  • Cross-Sectional Studies
  • Diethylhexyl Phthalate / chemistry*
  • Humans
  • Hypertension*
  • Linear Models
  • Phthalic Acids / adverse effects*
  • Phthalic Acids / chemistry*
  • Triglycerides / chemistry*
  • Triglycerides / metabolism


  • Phthalic Acids
  • Triglycerides
  • diisononyl phthalate
  • phthalic acid
  • Diethylhexyl Phthalate
  • butylbenzyl phthalate