Author + information
- Received December 5, 2018
- Revision received April 26, 2019
- Accepted June 24, 2019
- Published online September 2, 2019.
- Charline Warembourg, PhDa,b,c,
- Léa Maitre, PhDa,b,c,
- Ibon Tamayo-Uria, PhDa,b,c,
- Serena Fossati, MD, PhDa,b,c,
- Theano Roumeliotaki, MScd,
- Gunn Marit Aasvang, PhDe,
- Sandra Andrusaityte, PhDf,
- Maribel Casas, PhDa,b,c,
- Enrique Cequier, PhDe,
- Lida Chatzi, MD, PhDd,g,h,
- Audrius Dedele, PhDf,
- Juan-Ramon Gonzalez, PhDa,b,c,
- Regina Gražulevičienė, PhDf,
- Line Smastuen Haug, PhDe,
- Carles Hernandez-Ferrer, PhDa,b,c,
- Barbara Heude, PhDi,
- Marianna Karachaliou, MD, PhDd,
- Norun Hjertager Krog, PhDe,
- Rosemary McEachan, PhDj,
- Mark Nieuwenhuijsen, PhDa,b,c,
- Inga Petraviciene, PhDf,
- Joane Quentink,l,
- Oliver Robinson, PhDm,
- Amrit Kaur Sakhi, PhDe,
- Rémy Slama, PhDk,
- Cathrine Thomsen, PhDe,
- Jose Urquiza, PhDa,b,c,
- Marina Vafeiadi, PhDd,
- Jane West, PhDj,
- John Wright, MBChBj,
- Martine Vrijheid, PhDa,b,c and
- Xavier Basagaña, PhDa,b,c,∗ (, )@ISGlobalorg@Cha_Warembourg
- aISGlobal, Barcelona, Spain
- bUniversitat Pompeu Fabra (UPF), Barcelona, Spain
- cCIBER Epidemiologa y Salud Pública, Madrid, Spain
- dDepartment of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
- eNorwegian Institute of Public Health, Oslo, Norway
- fVytauto Didziojo Universitetas, Kaunus, Lithuania
- gDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- hDepartment of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- iINSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early ORigins of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, France
- jBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
- kInserm, Université Grenoble Alpes, CNRS, Institute of Advanced Biosciences, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France
- lCHU Grenoble Alpes, Grenoble, France
- mMRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- ↵∗Address for correspondence:
Dr. Xavier Basagaña, ISGlobal, Doctor Aiguader, 88 - 08003 Barcelona, Spain.
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.
The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007-206) under grant agreement no. 308333—the HELIX project. INMA data collections were supported by grants from the Instituto de Salud Carlos III, CIBERESP, and the Generalitat de Catalunya-CIRIT. KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). The Norwegian Mother and Child Cohort Study (MoBa) is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, National Institutes of Health/National Institute of Environmental Health Sciences (contract no N01-ES-75558), and National Institutes of Health/National Institute of Neurological Disorders and Stroke (grant no. 1 UO1 NS 047537-01 and grant no. 2 UO1 NS 047537-06A1). The Rhea project was financially supported by European projects and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011 to 2014; “Rhea Plus”: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012 to 2015). The work was also supported by MICINN (MTM2015-68140-R) and Centro Nacional de Genotipado-CEGEN-PRB2-ISCIII (Spain). This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Collaboration for Applied Health Research and Care (CLAHRC) for Yorkshire and Humber. Core support for Born in Bradford is also provided by the Wellcome Trust (WT101597MA, UK). Dr. Warembourg has received funding from the Fondation de France (00069251, France). Dr. Casas has received funding from Instituto de Salud Carlos III (Ministry of Economy and Competitiveness) (MS16/00128). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received December 5, 2018.
- Revision received April 26, 2019.
- Accepted June 24, 2019.
- 2019 American College of Cardiology Foundation
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