Exposure to Volatile Organic Compounds Is Associated with Hypertension in Black Adults: The Jackson Heart Study

Abstract

Background: The prevalence of hypertension is higher among Black adults than among White and Hispanic adults. Nevertheless, reasons underlying the higher rates of hypertension in the Black population remain unclear but may relate to exposure to environmental chemicals such as volatile organic compounds (VOCs).

Methods: We evaluated the associations of blood pressure (BP) and hypertension with VOC exposure in non-smokers and smokers in a subgroup of the Jackson Heart Study (JHS), consisting of 778 never smokers and 416 age- and sex-matched current smokers. We measured urinary metabolites of 17 VOCs by mass spectrometry.

Results: After adjusting for covariates, we found that amoong non-smokers, metabolites of acrolein and crotonaldehyde were associated with a 1.6 mm Hg (95%CI: 0.4, 2.7; p = 0.007) and a 0.8 mm Hg (95%CI: 0.01, 1.6; p = 0.049) higher systolic BP, and the styrene metabolite was associated with a 0.4 mm Hg (95%CI: 0.09, 0.8, p = 0.02) higher diastolic BP. Current smokers had 2.8 mm Hg (95% CI 0.5, 5.1) higher systolic BP. They were at higher risk of hypertension (relative risk = 1.2; 95% CI, 1.1, 1.4), and had higher urinary levels of several VOC metabolites. Individuals who smoke had higher levels of the urinary metabolites of acrolein, 1,3-butadiene, and crotonaldehyde and were associated with higher systolic BP. The associations were stronger among participants who were <60 years of age and male. Using Bayesian kernel machine regression to assess the effects of multiple VOC exposures, we found that the relationship between VOCs and hypertension among non-smokers was driven primarily by acrolein and styrene in non-smokers, and crotonaldehyde in smokers.

Conclusions: Hypertension in Black individuals may be attributed, in part, to VOC exposure from the environment or tobacco smoke.

Keywords: Blood pressure; Cardiovascular disease; Cotinine; Health disparities; Multipollutant exposures; Urinary metabolites.

Figure 1.. Associations between urinary VOC metabolites and BP and hypertension by 656 smoking status in participants of the Jackson Heart Study.

Urine samples were collected 657 from 1194 female and male participants of the Jackson Heart Study consisting of 778 non-658 smokers (urinary cotinine ≤40ng/mg) and 416 age- and sex-matched current smokers (urinary 659 cotinine >40ng/mg). Panels show differences in systolic (A) and diastolic (B) blood pressure (mm 660 Hg), and RR of hypertension (C), as well as 95% CI per IQR for each VOC metabolite shown on 661 the Y axis by smoking status: n=778 nonsmokers (open circles) and n=416 smokers (filled 662 circles). The levels of VOC metabolites (ng/mL) were normalized to the levels of creatinine 663 (mg/mL) in the urine (ng/mg creatinine). Models are adjusted for age, sex, BMI, physical activity, 664 education, eGFR, cholesterol:HDL, triglycerides, diabetes mellitus, blood pressure medications, 665 and ambient PM_2.5 levels on the day of enrollment.

Figure 2.. Associations between smoking and BP and hypertension.

From the Jackson Heart Study 1194 female and male participants were randomly selected consisting of 778 non-smokers (urinary cotinine ≤40ng/mg) and 416 age- and sex-matched current smokers (urinary cotinine >40ng/mg). Panels show differences in systolic (A) and diastolic (B) blood pressure (mm Hg), and RR of hypertension (C), as well as 95% CI as compared to non-smokers (Smoker,defined by urinary cotinine >40 ng/mg), or quartile of urinary cotinine (ng/mg creatinine, Cotinine Q2-Q4), or cigarettes per day (CPD) on the Y axis. Models were adjusted for age, sex, BMI, physical activity, education, eGFR, cholesterol:HDL, triglycerides, diabetes mellitus, blood pressure medications, and ambient levels of PM_2.5 on the day of enrollment.