Dynamic exposure to per- and polyfluoroalkyl substances and early alterations in cardiovascular hemodynamics: A 10-year longitudinal study in adolescents and young adults.
Journal
International journal of hygiene and environmental health
Journal Volume
276
Start Page
114845
ISSN
1618-131X
Date Issued
2026-06-05
Author(s)
Abstract
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental chemicals and have been implicated in cardiovascular risk. However, longitudinal evidence linking PFAS exposure to integrated cardiovascular hemodynamics, particularly in younger populations, remains limited. We conducted a longitudinal analysis within the Young Taiwanese Cohort (YOTA), including 310 adolescents and young adults followed for approximately 10 years. Serum PFAS concentrations and cardiovascular hemodynamic parameters (cardiac index, systemic vascular resistance (SVR), and left ventricular maximal rate of pressure rise (LV dP/dt)) were measured at baseline (2006-2008) and follow-up (2017-2019). A composite PFAS exposure index was constructed by calculating the mean of the standardized ln-transformed PFAS concentrations. Each 1-SD increase in the PFAS exposure index over time was associated with a 6.01% decrease in follow-up cardiac index and a 10.41% increase in follow-up SVR. Restricted cubic spline analyses demonstrated clear dose-response relationships with largely linear patterns. No significant associations were observed between PFAS exposure and LV dP/dt. Subgroup analyses identified baseline estimated glomerular filtration rate (eGFR) as an effect modifier for the PFAS-SVR association. The robustness of the findings was further supported by sensitivity analyses and quantile-based g-computation (qgcomp). In conclusion, longitudinal increases in PFAS exposure are associated with early, subclinical alterations in cardiovascular hemodynamics, characterized by increased vascular resistance and reduced cardiac output, but not impaired myocardial contractility. These findings suggest a vascular-dominant pathway linking PFAS exposure to cardiovascular dysregulation and highlight the importance of evaluating dynamic exposure trajectories and subclinical markers to understand the early cardiovascular impacts of persistent environmental chemicals.
Subjects
Cardiovascular hemodynamics
Longitudinal analysis
Per- and polyfluoroalkyl substances (PFAS)
Systemic vascular resistance
Young population
Type
journal article