'Forever Chemicals' May Raise Heart Disease Risks in Postmenopausal Women

New research suggests that the accumulation of per- and polyfluorinated substances (PFAS) in a woman's body after periods stop can negatively impact heart health.

Per- and polyfluorinated substances (PFAS) are potentially harmful chemicals manufacturers have used for decades to make cleaning products, food packaging materials, and household items like cookware. They are dubbed "forever chemicals" because they remain in the environment for years and can accumulate in humans. Studies suggest that more than 90% of people in the United States have forever chemicals in their bodies.

PFAS exposure is linked to certain types of cancer and may increase cancer cells' ability to spread. Moreover, PFAS may impact growth and metabolism in children.

However, new research suggests that certain groups may be more at risk of experiencing adverse health effects from PFAS exposure than others — specifically, women who have gone through menopause.

Exploring links between PFAS and heart health

Previous research found that menstruating women had lower concentrations of PFAS in their bodies than men. However, after menopause, those levels rise, likely due to the end of menstruation, as periods help remove forever chemicals from the body.

In light of these findings, researchers from the University of Illinois Urbana-Champaign wanted to determine whether PFAS levels — specifically perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorobutanesulfonic acid (PFBS) — could impact cardiovascular disease risks in older women.

Their research, published in Toxicological Sciences, involved 70 women between 45 and 78 years of age. Twenty-three participants had coronary microvascular disease (CMD), 21 had coronary artery disease (CAD), and 26 did not have a heart condition.

Using testing methods supported by machine learning techniques, the scientists tested the participants for all three forever chemicals, serum metabolites, and proteins associated with heart disease.

The results showed that participants from all three groups had PFOA, PFOS, and PFBS in their blood.

In addition, both forever chemicals interacted with proteins related to inflammation — a risk factor for cardiovascular conditions.

Specifically, elevated PFOA levels were associated with higher levels of amino acids called isoleucine and leucine, as well as elevated levels of pro-inflammatory cytokines. In contrast, higher PFOS concentrations were linked to lower isoleucine and leucine levels.

"We show that PFOS can be a good predictor of coronary artery disease, whereas PFOA can be an intermediate predictor of coronary microvascular disease. We also found that the PFAS levels in our study are significantly associated with inflammation-related proteins. Our findings may provide new insight into the potential mechanisms underlying the PFAS-induced risk of cardiovascular diseases in this population," the study's authors wrote.

Reducing PFAS exposure

According to the research team, in the U.S., officials banned PFOS and PFOA in 2002. Since 2003, PFBS has been used as a replacement for prohibited forever chemicals. However, the ban on PFOA didn't take effect until 2019.

Forever chemicals are found in several products, including firefighting foam, stain resistant clothing, and other household items. The scientists say there are no effective methods to remove forever chemicals once they get into the body, so women should avoid PFAS exposure by choosing PFAS-free clothing, cookware, and other products.

"We need more education as to how we can reduce our exposure to PFAS," said co-study author Madak-Erdogan, an associate professor in the University's Department of Food Science and Human Nutrition (FSHN), in a press release. "There also needs to be more action to regulate and mitigate these chemicals getting into the environment."

Recently, the U.S. Environmental Protection Agency (EPA) took steps to lessen exposure by imposing a national standard that limits five forever chemicals in drinking water. Moreover, several states, including Minnesota and Vermont, have banned the use of PFAS in some consumer products.