Log in

Bisphenol A, Hypertension, and Cardiovascular Diseases: Epidemiological, Laboratory, and Clinical Trial Evidence

  • Pathogenesis of Hypertension (W Elliott, Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Bisphenol A (BPA) exposure has become one of the most common environmental chemical exposures in humans. There is growing evidence regarding an association between BPA exposure, hypertension, and cardiovascular diseases (CVD). If BPA exposure is indeed associated with raised blood pressure and CVD, it would be a major public health problem. Therefore, we reviewed the epidemiological, laboratory, and clinical trial evidence for an association between BPA exposure, CVD, and hypertension, and discussed the possible mechanisms in this article. Cross-sectional studies in various ethnicities suggested a possible association between BPA exposure and hypertension; this association was supported by a panel study and a randomized clinical trial. Despite the discordance among cross-sectional studies about an association between BPA exposure and CVD, a longitudinal study shows that BPA exposure is a risk factor for CVD. The effects of BPA exposure such as endocrinal disturbance, induction of oxidative stress and inflammation, epigenetic change, and links with other chronic diseases may highlight a possible mechanism between BPA exposure, CVD, and hypertension. To clarify the causal relationship, well-designed studies are needed in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Burridge E. Bisphenol A: product profile. Eur Chem News. 2003;17:14–20.

    Google Scholar 

  2. Vandenberg LN, Maffini MV, Sonnenschein C, Rubin BS, Soto AM. Bisphenol-A and the great divide: a review of controversies in the field of endocrine disruption. Endocr Rev. 2009;30(1):75–95.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Calafat AM, Kuklenyik Z, Reidy JA, Caudill SP, Ekong J, Needham LL. Urinary concentrations of bisphenol A and 4-nonylphenol in a human reference population. Environ Health Perspect. 2005:391–5.

  4. Calafat AM, Ye X, Wong L-Y, Reidy JA, Needham LL. Exposure of the US population to bisphenol A and 4-tertiary-octylphenol: 2003–2004. Environ Health Perspect. 2008:39–44.

  5. Koch HM, Kolossa-Gehring M, Schröter-Kermani C, Angerer J, Brüning T. Bisphenol A in 24 h urine and plasma samples of the German Environmental Specimen Bank from 1995 to 2009: a retrospective exposure evaluation. J Expo Sci Environ Epidemiol. 2012;22(6):610–6.

    Article  CAS  PubMed  Google Scholar 

  6. Zhang Z, Alomirah H, Cho H-S, Li Y-F, Liao C, Minh TB, et al. Urinary bisphenol A concentrations and their implications for human exposure in several Asian countries. Environ Sci Technol. 2011;45(16):7044–50.

    Article  CAS  PubMed  Google Scholar 

  7. Wells EM, Jackson LW, Koontz MB. Decline in urinary bisphenol a concentrations in the United States. Epidemiology. 2013;24(1):167–8.

    Article  PubMed  Google Scholar 

  8. Kang J-H, Kondo F, Katayama Y. Human exposure to bisphenol A. Toxicology. 2006;226(2):79–89.

    Article  CAS  PubMed  Google Scholar 

  9. Dekant W, Völkel W. Human exposure to bisphenol A by biomonitoring: methods, results and assessment of environmental exposures. Toxicol Appl Pharmacol. 2008;228(1):114–34.

    Article  CAS  PubMed  Google Scholar 

  10. Völkel W, Colnot T, Csanády GA, Filser JG, Dekant W. Metabolism and kinetics of bisphenol A in humans at low doses following oral administration. Chem Res Toxicol. 2002;15(10):1281–7.

    Article  PubMed  Google Scholar 

  11. Stahlhut RW, Welshons WV, Swan SH. Bisphenol A data in NHANES suggest longer than expected half-life, substantial nonfood exposure, or both. Biomedical Sciences Publications (MU). 2009.

  12. Melzer D, Rice NE, Lewis C, Henley WE, Galloway TS. Association of urinary bisphenol A concentration with heart disease: evidence from NHANES 2003/06. PLoS One. 2010;5(1):e8673.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Rezg R, El-Fazaa S, Gharbi N, Mornagui B. Bisphenol A and human chronic diseases: current evidences, possible mechanisms, and future perspectives. Environ Int. 2014;64:83–90. Comprehensive review paper which summarizes the association between bisphenol A and various human chronic diseases.

    Article  CAS  PubMed  Google Scholar 

  14. Rancière F, Lyons JG, Loh VH, Botton J, Galloway T, Wang T, et al. Bisphenol A and the risk of cardiometabolic disorders: a systematic review with meta-analysis of the epidemiological evidence. Environ Heal. 2015;14(1):46.

    Article  Google Scholar 

  15. Shankar A, Teppala S. Urinary bisphenol A and hypertension in a multiethnic sample of US adults. J Environ Public Health. 2012;2012. First cross-sectional study to demonstrate the possible association between bisphenol A and hypertension.

  16. Aekplakorn W, Chailurkit L-O, Ongphiphadhanakul B. Association of serum bisphenol A with hypertension in Thai population. Int J Hypertens. 2015;2015.

  17. Shiue I. Higher urinary heavy metal, phthalate, and arsenic but not parabens concentrations in people with high blood pressure, US NHANES, 2011–2012. Int J Environ Res Public Health. 2014;11(6):5989–99.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Bae S, Kim JH, Lim Y-H, Park HY, Hong Y-C. Associations of bisphenol A exposure with heart rate variability and blood pressure. Hypertension. 2012;60(3):786–93. This study found the association between bisphenol A exposure and increased blood pressure by analyzing elderly panel data.

    Article  CAS  PubMed  Google Scholar 

  19. Bae S, Hong Y-C. Exposure to bisphenol A from drinking canned beverages increases blood pressure randomized crossover trial. Hypertension. 2015;65(2):313–9. Randomized crossover trial study showing that bisphenol A exposure from drinking canned beverage increases elderly blood pressure.

    Article  CAS  PubMed  Google Scholar 

  20. Lang IA, Galloway TS, Scarlett A, Henley WE, Depledge M, Wallace RB, et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008;300(11):1303–10. First cross-sectional study to demonstrate the possible association between bisphenol A and cardiovascular diseases.

    Article  CAS  PubMed  Google Scholar 

  21. Shankar A, Teppala S, Sabanayagam C. Bisphenol A and peripheral arterial disease: results from the NHANES. Environ Health Perspect. 2012;120(9):1297.

    Article  PubMed Central  PubMed  Google Scholar 

  22. LaKind JS, Goodman M, Naiman DQ. Use of NHANES data to link chemical exposures to chronic diseases: a cautionary tale. 2012.

  23. Casey MF, Neidell M. Disconcordance in statistical models of bisphenol A and chronic disease outcomes in NHANES 2003-08. PLoS One. 2013;8(11):e79944. doi:10.1371/journal.pone.0079944.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Olsen L, Lind L, Lind PM. Associations between circulating levels of bisphenol A and phthalate metabolites and coronary risk in the elderly. Ecotoxicol Environ Saf. 2012;80:179–83.

    Article  CAS  PubMed  Google Scholar 

  25. Melzer D, Osborne NJ, Henley WE, Cipelli R, Young A, Money C, et al. Urinary bisphenol A concentration and risk of future coronary artery disease in apparently healthy men and women. Circulation. 2012;125(12):1482–90. Longitudinal study which demonstrates the association between bisphennol A exposure and coronary arterial disease.

    Article  CAS  PubMed  Google Scholar 

  26. Lind PM, Lind L. Circulating levels of bisphenol A and phthalates are related to carotid atherosclerosis in the elderly. Atherosclerosis. 2011;218(1):207–13.

    Article  CAS  PubMed  Google Scholar 

  27. Melzer D, Gates P, Osborn NJ, Henley WE, Cipelli R, Young A, et al. Urinary bisphenol a concentration and angiography-defined coronary artery stenosis. 2012.

  28. Lin C-Y, Shen F-Y, Lian G-W, Chien K-L, Sung F-C, Chen P-C, et al. Association between levels of serum bisphenol A, a potentially harmful chemical in plastic containers, and carotid artery intima-media thickness in adolescents and young adults. Atherosclerosis. 2015;241(2):657–63.

    Article  CAS  PubMed  Google Scholar 

  29. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–71.

    Article  CAS  PubMed  Google Scholar 

  30. HIROI H, TSUTSUMI O, MOMOEDA M, TAKAI Y, OSUGA Y, TAKETANI Y. Differential interactions of biphenol A and 17beta-estradiol with estrogen receptor alpha and estrogen receptor beta. Endocr J. 1999;46(6):773–8.

    Article  CAS  PubMed  Google Scholar 

  31. Bonefeld-Jorgensen EC, Long M, Hofmeister MV, Vinggaard AM. Endocrine-disrupting potential of bisphenol A, bisphenol A dimethacrylate, 4-n-nonylphenol, and 4-n-octylphenol in vitro: new data and a brief review. Environ Health Perspect. 2007;115:69.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Okada H, Tokunaga T, Liu X, Takayanagi S, Matsushima A, Shimohigashi Y. Direct evidence revealing structural elements essential for the high binding ability of bisphenol A to human estrogen-related receptor-γ. Environ Health Perspect. 2008:32–8.

  33. Mastin JP. Environmental cardiovascular disease. Cardiovasc Toxicol. 2005;5(2):91–4.

    Article  CAS  PubMed  Google Scholar 

  34. Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002;89(12):12–7.

    Article  Google Scholar 

  35. Asano S, Tune JD, Dick GM. Bisphenol A activates Maxi-K (KCa1. 1) channels in coronary smooth muscle. Br J Pharmacol. 2010;160(1):160–70.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Sriphrapradang C, Chailurkit L-O, Aekplakorn W, Ongphiphadhanakul B. Association between bisphenol A and abnormal free thyroxine level in men. Endocrine. 2013;44(2):441–7.

    Article  CAS  PubMed  Google Scholar 

  37. Ropero A, Alonso-Magdalena P, García-García E, Ripoll C, Fuentes E, Nadal A. Bisphenol-A disruption of the endocrine pancreas and blood glucose homeostasis. Int J Androl. 2008;31(2):194–200.

    Article  CAS  PubMed  Google Scholar 

  38. Yang YJ, Hong Y-C, Oh S-Y, Park M-S, Kim H, Leem J-H, et al. Bisphenol A exposure is associated with oxidative stress and inflammation in postmenopausal women. Environ Res. 2009;109(6):797–801.

    Article  CAS  PubMed  Google Scholar 

  39. Savastano S, Tarantino G, D’Esposito V, Passaretti F, Cabaro S, Liotti A, et al. Bisphenol-A plasma levels are related to inflammatory markers, visceral obesity and insulin-resistance: a cross-sectional study on adult male population. J Transl Med. 2015;13(1):1–7.

    Article  CAS  Google Scholar 

  40. Mourad IM, Khadrawy YA. The sensetivity of liver, kidney andtestis of rats to oxidative stress induced by different doses of bisphenol A. Life. 2012;50:19.

    Google Scholar 

  41. Bindhumol V, Chitra K, Mathur P. Bisphenol A induces reactive oxygen species generation in the liver of male rats. Toxicology. 2003;188(2):117–24.

    Article  CAS  PubMed  Google Scholar 

  42. Ezz HSA, Khadrawy YA, Mourad IM. The effect of bisphenol A on some oxidative stress parameters and acetylcholinesterase activity in the heart of male albino rats. Cytotechnology. 2013;67(1):145–55.

    PubMed Central  PubMed  Google Scholar 

  43. Lund G, Zaina S. Atherosclerosis: an epigenetic balancing act that goes wrong. Curr Atheroscler Rep. 2011;13(3):208–14.

    Article  CAS  PubMed  Google Scholar 

  44. El Shamieh S, Visvikis-Siest S. Genetic biomarkers of hypertension and future challenges integrating epigenomics. Clin Chim Acta. 2012;414:259–65.

    Article  PubMed  Google Scholar 

  45. Singh S, Li SS-L. Epigenetic effects of environmental chemicals bisphenol a and phthalates. Int J Mol Sci. 2012;13(8):10143–53.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yun-Chul Hong.

Ethics declarations

Conflict of Interest

Changwoo Han and Yun-Chul Hong declare that they have no conflict of interests.

Human and Animal Rights and Informed Consent

This article contains studies with human subjects performed by the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

This article is part of the Topical Collection on Pathogenesis of Hypertension

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Han, C., Hong, YC. Bisphenol A, Hypertension, and Cardiovascular Diseases: Epidemiological, Laboratory, and Clinical Trial Evidence. Curr Hypertens Rep 18, 11 (2016). https://doi.org/10.1007/s11906-015-0617-2

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11906-015-0617-2

Keywords

Navigation