Study Linking PFOA Exposure to CVD and PAD Highlights Need for Regulation

Exposure to perfluorooctanoic acid (PFOA), a manmade chemical used in the manufacture of common household consumer products, is associated with cardiovascular disease (CVD) and peripheral arterial disease (PAD), independent of traditional cardiovascular risk factors, according to a study published on Sept. 3 in the Archives of Internal Medicine (Arch Intern Med).

The study, which is based on data from 1,216 participants in the National Health and Nutritional Examination Survey from 1999 to 2003, found that increasing serum PFOA levels are positively associated with CVD and PAD, independent of age, sex, race/ethnicity, smoking status, body mass index, diabetes mellitus, hypertension, and serum cholesterol level.

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According to the study authors, the results have important public health implications given that serum PFOA levels appear to be positively related to CVD outcomes even at relatively low "background" exposure levels in the U.S. general population. "Because all PFOA is manmade, this excess risk may be removed or substantially mitigated through regulation or by emerging pharmacological means that need to be further studied," the authors said. "If our findings are replicated in future prospective studies, the population-attributable risk of PFOA exposure on CVD risk could potentially be high."

In an invited commentary on the study's findings, Debabrata Mukherjee, MD, MS, FACC, editor of the ACC's Interventional Clinical Collection on, further highlights the importance of these findings as they relate to public health. "Although it seems clear that additional prospective research is needed to tease out the true adverse cardiovascular effects of PFOA," he says, "given the concerns raised by this and prior studies, clinicians will need to act now." Mukherjee recommends legislation and regulation, as well as improved technique, to eliminate PFOA from water and other potential sources.

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