Abstract P185: Racial Disparities In The Influence Of Endocrine-Disrupting Chemicals On Hypertension-Related Mortality In The US Adult Population

Abstract

Bisphenol A (BPA) is an endocrine-disruptive chemical derived from plastics and epoxies which have been linked to atherosclerosis and obesity. Cardiovascular disease (CVD) also disproportionately affects minority populations. Among environmental toxins, Black Americans are found to have higher BPA levels than the general population. In this study, we assessed the hypothesis that if BPA leads to higher mortality outcomes among individuals with hypertension only in Non-Hispanic Black Americans.From the 2003-2010 National Health and Nutrition Examination Survey, we analyzed data on adults (≥ 20 years), with mortality data obtained through 2015. Hypertension status was determined from medication usage information and self-report status. The causes of death for adults (N=3407) were defined using the International Classification of Disease coding (ICD-10). Urinary BPA levels were considered elevated at ≥1.97 μg/g. Complex Samples Cox Regression was used to assess if BPA levels influence the effect of hypertension on mortality and if this pattern persists across races. Out of the Non-Hispanic Black respondents, 10.5% of males died from hypertension versus 13.1% of females. During the 8.6-year follow-up, the unadjusted hazard ratio (HR) of hypertension to no hypertension for Non-Hispanic Black Adults was 3.22; 95% confidence interval [CI: 2.19-4.75]. The adjusted HR was elevated, 2.98 (CI 1.19-7.46, p = 0.02), among BPA-exposed individuals but closer to 1.0 (1.08 CI 0.45-2.59, p = 0.87) among unexposed individuals, after controlling for medical and demographic risk factors. However, among Non-Hispanic White individuals, increased BPA levels did not significantly influence mortality in those individuals with hypertension. In conclusion, there was increased mortality outcomes among BPA-exposed, Non-Hispanic Black individuals experiencing hypertension than those individuals without hypertension. Due to the chronicity of exposure among environmental hazards, social disparities are compounded over a long period of time. Environmental exposures like BPA should be monitored especially among vulnerable populations and thereby improve hypertension related health outcomes.