Phthalates may disrupt heart rate variability and cardiovascular reactivity. - GreenMedInfo Summary
PLASTICS AND CARDIOVASCULAR HEALTH: PHTHALATES MAY DISRUPT HEART RATE VARIABILITY AND CARDIOVASCULAR REACTIVITY.
Am J Physiol Heart Circ Physiol. 2017 Aug 25:ajpheart.00364.2017. Epub 2017 Aug 25. PMID: 28842438
BACKGROUND: Plastics have revolutionized medical device technology, transformed hematological care, and facilitated modern cardiology procedures. Despite these advances, studies have shown that phthalate chemicals migrate out of plastic products, and that these chemicals are bioactive. Recent epidemiological and research studies suggest that phthalate exposure adversely affects cardiovascular function.
OBJECTIVE: To assess the safety and biocompatibility of phthalate chemicals, and resolve the impact on cardiovascular and autonomic physiology.
METHODS: Adult mice were implanted with radiofrequency transmitters to monitor heart rate variability, blood pressure, and autonomic regulation in response to di-2-ethylhexyl-phthalate (DEHP) exposure.
RESULTS: DEHP-treated animals displayed a decrease in heart rate variability (-17% SDNN, -36% high frequency power) and an exaggerated mean arterial pressure (MAP) response to ganglionic blockade (31.5% via chlorisondamine). In response to a conditioned stressor, DEHP-treated animals displayed enhanced cardiovascular reactivity (-56% SD2, standard deviation, major axis Poincarè plot) and prolonged blood pressure recovery. Alterations in cardiac gene expression of endothelin-1, angiotensin converting enzyme, and nitric oxide synthase may partly explain these cardiovascular alterations.
CONCLUSIONS: This is the first study to show an association between phthalate chemicals that are used in medical devices with alterations in autonomic regulation, heart rate variability and cardiovascular reactivity. Since changes in autonomic balance often precede clinical manifestations of hypertension, atherosclerosis and conduction abnormalities - future studies are warranted to assess the downstream impact of plastic chemical exposure on end-organ function in sensitive patient populations. This study also highlights the importance of adopting safer biomaterials, chemicals, and/or surface coatings for use in medical devices.