Association of Volatile Organic Compound Exposure with Blood Pressure in the National Health and Nutrition Examination Survey (2011-2016)

Abstract

BACKGROUND AND AIM Volatile organic compounds (VOCs) are environmental pollutants generated from a variety of different combustion sources, consumer and household products, and tobacco smoke. Exposure to VOCs has been associated with cardiovascular disease (CVD) risk factors, such as increased blood pressure (BP); however, limited research has been conducted in the general population. We hypothesized that higher levels of VOC exposure are associated with higher BP. METHODS To examine the relationship between VOC exposure and BP, we acquired and combined three cycles of data from the National Health and Nutrition Examination Survey (NHANES) over the years 2011-2016 for a final sample size of n=5,616 participants. Ultra-performance liquid chromatography/mass-spectrometry was used to measure the levels of 27 urinary VOC metabolites. Metabolites were adjusted for urinary creatinine and multiple measures of systolic and diastolic BP were averaged. Linear regression models adjusted for age, sex, race, education, BMI, smoking status, HDL, cholesterol, triglycerides, diabetes, blood pressure medications, eGFR, and NHANES cycle year were used to estimate associations between VOC metabolites and BP. RESULTS Participants were 52% female, median age of 47, 32% had hypertension, and 7.4% had diabetes. Urinary VOC metabolites were higher among tobacco users than non-users, except for metabolites of benzene, cyanide, and toluene. We found a 0.6 (95% CI: 0.2, 1.0) mmHg higher systolic BP per interquartile range of 1,3-butadiene metabolite, DHBMA. In subgroup analysis, this association was independent of age and persisted in women, non-tobacco users, Mexican Americans, and individuals not diagnosed with CVD or hypertension. Urinary metabolites of acrolein were associated with systolic BP in non-tobacco users, Non-Hispanic Blacks, women, and individuals not diagnosed with CVD or hypertension. CONCLUSIONS These results suggest exposures to VOCs, particularly acrolein and 1,3-butadiene, may be relevant, yet understudied contributors to CVD risk in the general population. KEYWORDS blood pressure, vocs, cvd, chemicals