Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50: A longitudinal birth cohort study

Michele La Merrill, Piera M. Cirillo, Mary Beth Terry, Nickilou Y. Krigbaum, Julie D. Flom, Barbara A. Cohn

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p'- and o,p'-) and its metabolite p,p'-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39-47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p'-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p ́-DDT relative to the lowest tertile, respectively]. These associations between p,p ́-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development.

Original languageEnglish (US)
Pages (from-to)594-599
Number of pages6
JournalEnvironmental Health Perspectives
Volume121
Issue number5
DOIs
StatePublished - May 1 2013

Fingerprint

Pesticides
Cohort Studies
Parturition
Hypertension
Dichlorodiphenyl Dichloroethylene
San Francisco
Child Development
Nuclear Family
Proportional Hazards Models
Regression Analysis
Mothers
Interviews
Blood Pressure
Physicians
Serum

Keywords

  • Blood pressure
  • DDT
  • Hypertension
  • Life course
  • Prenatal

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50 : A longitudinal birth cohort study. / La Merrill, Michele; Cirillo, Piera M.; Terry, Mary Beth; Krigbaum, Nickilou Y.; Flom, Julie D.; Cohn, Barbara A.

In: Environmental Health Perspectives, Vol. 121, No. 5, 01.05.2013, p. 594-599.

Research output: Contribution to journalArticle

La Merrill, Michele ; Cirillo, Piera M. ; Terry, Mary Beth ; Krigbaum, Nickilou Y. ; Flom, Julie D. ; Cohn, Barbara A. / Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50 : A longitudinal birth cohort study. In: Environmental Health Perspectives. 2013 ; Vol. 121, No. 5. pp. 594-599.
@article{32bcd1110f0e4560a3089d09ad8459b5,
title = "Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50: A longitudinal birth cohort study",
abstract = "Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p'- and o,p'-) and its metabolite p,p'-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39-47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p'-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95{\%} CI: 1.8, 7.2 and aHR = 2.5; 95{\%} CI: 1.2, 5.3 for middle and high tertiles of p,p ́-DDT relative to the lowest tertile, respectively]. These associations between p,p ́-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development.",
keywords = "Blood pressure, DDT, Hypertension, Life course, Prenatal",
author = "{La Merrill}, Michele and Cirillo, {Piera M.} and Terry, {Mary Beth} and Krigbaum, {Nickilou Y.} and Flom, {Julie D.} and Cohn, {Barbara A.}",
year = "2013",
month = "5",
day = "1",
doi = "10.1289/ehp.1205921",
language = "English (US)",
volume = "121",
pages = "594--599",
journal = "Environmental Health Perspectives",
issn = "0091-6765",
publisher = "Public Health Services, US Dept of Health and Human Services",
number = "5",

}

TY - JOUR

T1 - Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50

T2 - A longitudinal birth cohort study

AU - La Merrill, Michele

AU - Cirillo, Piera M.

AU - Terry, Mary Beth

AU - Krigbaum, Nickilou Y.

AU - Flom, Julie D.

AU - Cohn, Barbara A.

PY - 2013/5/1

Y1 - 2013/5/1

N2 - Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p'- and o,p'-) and its metabolite p,p'-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39-47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p'-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p ́-DDT relative to the lowest tertile, respectively]. These associations between p,p ́-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development.

AB - Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p'- and o,p'-) and its metabolite p,p'-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39-47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p'-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p ́-DDT relative to the lowest tertile, respectively]. These associations between p,p ́-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development.

KW - Blood pressure

KW - DDT

KW - Hypertension

KW - Life course

KW - Prenatal

UR - http://www.scopus.com/inward/record.url?scp=84876358451&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876358451&partnerID=8YFLogxK

U2 - 10.1289/ehp.1205921

DO - 10.1289/ehp.1205921

M3 - Article

C2 - 23591545

AN - SCOPUS:84876358451

VL - 121

SP - 594

EP - 599

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 5

ER -