Association between serum concentrations of persistent organic pollutants and self-reported cardiovascular disease prevalence: Results from the National Health and Nutrition Examination Survey, 1999-2002

Background: There is now increasing evidence that exposure to persistent organic pollutants (POPs) can contribute to the development of inflammatory diseases such as atherosclerosis. Objective: The objective of this study was to examine associations of serum concentrations of POPs with self-reported history of cardiovascular disease (CVD). Design: Cross-sectional associations of serum POPs concentrations with the prevalence of self-reported CVD were investigated in 889 adults ≥ 40 years of age in the National Health and Nutrition Examination Survey, 1999-2002. We selected 21 POPs [3 polychlorinated dibenzo-p-dioxins (PCDDs), 3 polychlorinated dibenzofurans (PCDFs), 5 dioxin-like polychlorinated biphenyls (PCBs), 6 nondioxin-like PCBs, and 4 organochlorine (OC) pesticides] because they were detectable in ≥ 60% of participants. Results: Dioxin-like PCBs, nondioxin-like PCBs, and OC pesticides were positively associated with the prevalence of CVD only among females. Compared with those in the lowest quartile of serum concentration, the odds ratios for CVD across increasing quartiles were 0.9, 2.0, and 5.0 for dioxin-like PCBs (p for trend < 0.01), 1.2, 1.2, and 3.8 for nondioxin-like PCBs (p for trend < 0.01), and 1.9, 1.7, and 4.0 for OC pesticides (p for trend = 0.03). PCDDs showed positive trends with the prevalence of CVD in both males and females; adjusted odds ratios were 1.4, 1.7, and 1.9 (p for trend = 0.07, males and females combined). Conclusions: Our findings need to be carefully interpreted because of the cross-sectional design and use of self-reported CVD. Prospective studies are needed to clarify these associations.