Early-Life Environmental Exposures and Blood Pressure in Children

J Am Coll Cardiol. 2019 Sep 10;74(10):1317-1328. doi: 10.1016/j.jacc.2019.06.069.

Abstract

Background: Growing evidence exists about the fetal and environmental origins of hypertension, but mainly limited to single-exposure studies. The exposome has been proposed as a more holistic approach by studying many exposures simultaneously.

Objectives: This study aims to evaluate the association between a wide range of prenatal and postnatal exposures and blood pressure (BP) in children.

Methods: Systolic and diastolic BP were measured among 1,277 children from the European HELIX (Human Early-Life Exposome) cohort aged 6 to 11 years. Prenatal (n = 89) and postnatal (n = 128) exposures include air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals, and lifestyles. Two methods adjusted for confounders were applied: an exposome-wide association study considering the exposures independently, and the deletion-substitution-addition algorithm considering all the exposures simultaneously.

Results: Decreases in systolic BP were observed with facility density (β change for an interquartile-range increase in exposure: -1.7 mm Hg [95% confidence interval (CI): -2.5 to -0.8 mm Hg]), maternal concentrations of polychlorinated biphenyl 118 (-1.4 mm Hg [95% CI: -2.6 to -0.2 mm Hg]) and child concentrations of dichlorodiphenyldichloroethylene (DDE: -1.6 mm Hg [95% CI: -2.4 to -0.7 mm Hg]), hexachlorobenzene (-1.5 mm Hg [95% CI: -2.4 to -0.6 mm Hg]), and mono-benzyl phthalate (-0.7 mm Hg [95% CI: -1.3 to -0.1 mm Hg]), whereas increases in systolic BP were observed with outdoor temperature during pregnancy (1.6 mm Hg [95% CI: 0.2 to 2.9 mm Hg]), high fish intake during pregnancy (2.0 mm Hg [95% CI: 0.4 to 3.5 mm Hg]), maternal cotinine concentrations (1.2 mm Hg [95% CI: -0.3 to 2.8 mm Hg]), and child perfluorooctanoate concentrations (0.9 mm Hg [95% CI: 0.1 to 1.6 mm Hg]). Decreases in diastolic BP were observed with outdoor temperature at examination (-1.4 mm Hg [95% CI: -2.3 to -0.5 mm Hg]) and child DDE concentrations (-1.1 mm Hg [95% CI: -1.9 to -0.3 mm Hg]), whereas increases in diastolic BP were observed with maternal bisphenol-A concentrations (0.7 mm Hg [95% CI: 0.1 to 1.4 mm Hg]), high fish intake during pregnancy (1.2 mm Hg [95% CI: -0.2 to 2.7 mm Hg]), and child copper concentrations (0.9 mm Hg [95% CI: 0.3 to 1.6 mm Hg]).

Conclusions: This study suggests that early-life exposure to several chemicals, as well as built environment and meteorological factors, may affect BP in children.

Keywords: blood pressure; chemicals; children; cohort; environment; epidemiology; exposome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure / drug effects
  • Blood Pressure Determination / methods
  • Blood Pressure Determination / statistics & numerical data
  • Built Environment
  • Child
  • Dichlorodiphenyl Dichloroethylene / analysis
  • Environmental Exposure* / adverse effects
  • Environmental Exposure* / classification
  • Environmental Exposure* / prevention & control
  • Environmental Pollutants* / adverse effects
  • Environmental Pollutants* / analysis
  • Europe / epidemiology
  • Female
  • Holistic Health
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Hypertension* / prevention & control
  • Insecticides / adverse effects
  • Insecticides / analysis
  • Male
  • Meteorological Concepts
  • Polychlorinated Biphenyls / analysis
  • Pregnancy
  • Prenatal Exposure Delayed Effects* / blood
  • Prenatal Exposure Delayed Effects* / diagnosis
  • Prenatal Exposure Delayed Effects* / epidemiology

Substances

  • Environmental Pollutants
  • Insecticides
  • Dichlorodiphenyl Dichloroethylene
  • Polychlorinated Biphenyls