Plastic Chemical Bisphenol A Dampens Our Cardiovascular System: Evidence from Clinical and Animal Studies
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The environmental exposure of Bisphenol A (BPA) is a pervasive and growing concern. BPA is a high-volume industrial chemical that possesses estrogen-like properties and functions as an environmental endocrine disruptor. It is used extensively in the production of polycarbonate plastics and epoxy resins for food and beverage packages and hygienic products. An increasing amount of plastic pollution prevalent throughout the world has resulted in the nearly ubiquitous exposure of BPA towards humans and animals alike. Concerns have surfaced accordingly, surrounding the potentially detrimental effects that might result from BPA leaching into foods and beverages. The increase in epidemiological studies related to BPA have since been able to conclude links between BPA-induced oxidative stress, cardiovascular diseases, and hypertension. This review will incorporate current literature examining BPA exposure through clinical and epidemiological trials; these trials will encompass the physiological and toxicological effects that BPA can impose on the human cardiovascular system.
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2. Ocean Conservancy. Fighting for Trash Free Seas. Ocean Conservancy. [online]
3. Bläsing M, Wulf A. Plastics in soil: Analytical methods and possible sources. Science of The Total Environment. 2018; 612: 422-435.
4. Moore S. AZO Materials. “Using Enzymes and Microorganisms to Improve the Future of Plastic Recycling”. Published in 2020. [online]
5. Lau WWY, Shiran Y, Bailey R.M, Cook E, Stuchtey M.R, Koskella J, Velis C.A, Godfrey L, Boucher J, Murphy M.B, Thompson R.C, Jankowska E, Castillo-Castillo A, Pilditch T.D, Dixon B, Koerselman L, Kosior E, Favoino E, Gutberlet J, Baulch S, Atreya M.E, Fischer D, He K.K, Petit M.M, Sumaila U.R, Neil E, Bernhofen M.V, Lawrence K., Palardy J.E. Evaluating scenarios toward zero plastic pollution. Science. 2020; 369(6510):1455-1461.
6. Medical News Today. “How does bisphenol A affect health?” Published in 2021. [online]
7. Sacks D, Baxter B, Campbell B.C.V, Carpenter J.S, Cognard C, Dippel D, Eesa M, Fischer U, Hausegger K, Hirsch J.A, Shazam Hussain M, Jansen O, Jayaraman M.V, Khalessi A.A, Kluck B.W, Lavine S, Meyers P.M, Ramee S, Rüfenacht D.A, Schirmer C.M, Vorwerk D. Multisociety Consensus Quality Improvement Revised Consensus Statement for Endovascular Therapy of Acute Ischemic Stroke. Int J Stroke. 2018; 13(6): 612-632.
8. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nature Reviews Nephrology. 2020; 16(4): 223-237.
9. Centers for Disease Control and Prevention (CDC). Heart Disease Facts. Published in 2020. [online]
10. Melzer D, Rice N.E, Lewis C, Henley W.E, Galloway T.S. Association of Urinary Bisphenol A Concentration with Heart Disease: Evidence from NHANES 2003/06. PLOS ONE. 2010; 5(1):e8673.
11. Shankar A, Teppala S. Urinary bisphenol A and hypertension in a multiethnic sample of US adults. J Environ Public Health. 2012; 2012:481641.
12. Gao X, Wang H.S. Impact of bisphenol a on the cardiovascular system - epidemiological and experimental evidence and molecular mechanisms. Int J Environ Res Public Health. 2014; 11(8): 8399-8413.
13. Rancière F, Lyons J.G, Loh V.H, Botton J, Galloway T, Wang T, Shaw J.E, Magliano D.J. Bisphenol A and the risk of cardiometabolic disorders: a systematic review with meta-analysis of the epidemiological evidence. Environ Health. 2015; 14(1): 1-23.
14. Bae S, Kim J.H, Lim Y.H, Park H.Y, Hong Y.C. Associations of bisphenol A exposure with heart rate variability and blood pressure. Hypertension. 2012; 60(3): 786-793.
15. Bae S, Hong Y.C. Exposure to bisphenol A from drinking canned beverages increases blood pressure: randomized crossover trial. Hypertension. 2015; 65(2): 313-319.
16. Jiang S, Liu H, Zhou S, Zhang X, Peng C, Zhou H, Tong Y, Lu Q. Association of bisphenol A and its alternatives bisphenol S and F exposure with hypertension and blood pressure: A cross-sectional study in China. Environ Pollut. 2020; 257: 113639.
17. Aekplakorn W, Chailurkit L.O, Ongphiphadhanakul B. Association of serum bisphenol a with hypertension in thai population. Int J Hypertens. 2015; 2015:594189.
18. Mouneimne Y, Nasrallah M, Khoueiry-Zgheib N, Nasreddine L, Nakhoul N, Ismail H, Abiad M, Koleilat L, Tamim H. Bisphenol A urinary level, its correlates, and association with cardiometabolic risks in Lebanese urban adults. Environ Monit Assess. 2017; 189(10): 1-13.
19. Bae S, Lim Y.H, Lee Y.A, Shin C.H, Oh S.Y, Hong Y.C. Maternal Urinary Bisphenol A Concentration During Midterm Pregnancy and Children's Blood Pressure at Age 4. Hypertension. 2017; 69(2): 367-374.
20. Warembourg C, Maitre L, Tamayo-Uria I, Fossati S, Roumeliotaki T, Aasvang G.M, Andrusaityte S, Casas M, Cequier E, Chatzi L, Dedele A, Gonzalez J.R, Gražulevičienė R, Haug L.S, Hernandez-Ferrer C, Heude B, Karachaliou M, Krog N.H, McEachan R, Nieuwenhuijsen M, Petraviciene I, Quentin J, Robinson O, Sakhi A.K, Slama R, Thomsen C, Urquiza J, Vafeiadi M, West J, Wright J, Vrijheid M, Basagaña X. Early-Life Environmental Exposures and Blood Pressure in Children. J Am Coll Cardiol. 2019; 74(10): 1317-1328.
21. Philips EM, Trasande L, Kahn L.G, Gaillard R, Steegers E.A.P, Jaddoe V.W.V. Early pregnancy bisphenol and phthalate metabolite levels, maternal hemodynamics and gestational hypertensive disorders. Hum Reprod. 2019; 34(2): 365-373.
22. Hu J, Wang Y, Xiang X, Peng C, Gao R, Goswami R, Zhou H, Zhang Y, Zhen Q, Cheng Q, Yang S, Li Q. Serum bisphenol A as a predictor of chronic kidney disease progression in primary hypertension: a 6-year prospective study. J Hypertens. 2016; 34(2): 332-337.
23. Salamanca-Fernández E, Vela-Soria F, Rodríguez-Barranco M, Arrebola-Moreno A, Iribarne-Durán L.M, Olea N, Sánchez M.J, Arrebola J.P. Serum levels of non-persistent environmental pollutants and risk of incident hypertension in a sub-cohort from the EPIC study. Environ Res. 2021; 193: 110491.
24. Piecha R, Svačina Š, Malý M, Vrbík K, Lacinová Z, Haluzík M, Pavloušková J, Vavrouš A, Matějková D, Müllerová D, Mráz M, Matoulek M. Urine Levels of Phthalate Metabolites and Bisphenol A in Relation to Main Metabolic Syndrome Components: Dyslipidemia, Hypertension and Type 2 Diabetes. A Pilot Study. Cent Eur J Public Health. 2016; 24(4): 297-301.
25. Camara LR, Arbuckle T.E, Trottier H, Fraser W.D. Associations between Maternal Exposure to Bisphenol A or Triclosan and Gestational Hypertension and Preeclampsia: The MIREC Study. Am J Perinatol. 2019; 36(11): 1127-1135.
26. Kim MJ, Moon M.K, Kang G.H, Lee K.J, Choi S.H, Lim S, Oh B.C, Park D.J, Park K.S, Jang H.C, Park Y.J. Chronic exposure to bisphenol A can accelerate atherosclerosis in high-fat-fed apolipoprotein E knockout mice. Cardiovasc Toxicol. 2014; 14(2): 120-128.
27. Sui Y, Park S.H, Helsley R.N, Sunkara M, Gonzalez F.J, Morris A.J, Zhou C. Bisphenol A increases atherosclerosis in pregnane X receptor-humanized ApoE deficient mice. J Am Heart Assoc. 2014; 3(2): e000492.
28. Sui Y, Park S.H, Wang F, Zhou C. Perinatal Bisphenol A Exposure Increases Atherosclerosis in Adult Male PXR-Humanized Mice. Endocrinology. 2018; 159(4): 1595-1608.
29. Fang C, Ning B, Waqar A.B, Niimi M, Li S, Satoh K, Shiomi M, Ye T, Dong S, Fan J. Bisphenol A exposure enhances atherosclerosis in WHHL rabbits. PLoS One. 2014; 9(10): e110977.
30. Fang C, Ning B, Waqar A.B, Niimi M, Li S, Satoh K, Shiomi M, Ye T, Dong S, Fan J. Bisphenol A exposure induces metabolic disorders and enhances atherosclerosis in hyperlipidemic rabbits. J Appl Toxicol. 2015; 35(9): 1058-1070.
31. Aboul Ezz HS, Khadrawy Y.A, Mourad I.M. The effect of bisphenol A on some oxidative stress parameters and acetylcholinesterase activity in the heart of male albino rats. Cytotechnology. 2015; 67(1): 145-155.
32. Wang K, Zhao Z, Ji W. Bisphenol A induces apoptosis, oxidative stress and inflammatory response in colon and liver of mice in a mitochondria-dependent manner. Biomed Pharmacother. 2019; 117: 109182.
33. Moghaddam HS, Samarghandian S, Farkhondeh T. Effect of bisphenol A on blood glucose, lipid profile and oxidative stress indices in adult male mice. Toxicol Mech Methods. 2015; 25(7): 507-513.
34. Tiwari D, Vanage G. Bisphenol A Induces Oxidative Stress in Bone Marrow Cells, Lymphocytes, and Reproductive Organs of Holtzman Rats. Int J Toxicol. 2017; 36(2): 142-152.
35. Xu H, Yang M, Qiu W, Pan C, Wu M. The impact of endocrine-disrupting chemicals on oxidative stress and innate immune response in zebrafish embryos. Environ Toxicol Chem. 2013; 32(8): 1793-1799.
36. Hulak M, Gazo I, Shaliutina A, Linhartova P. In vitro effects of bisphenol A on the quality parameters, oxidative stress, DNA integrity and adenosine triphosphate content in sterlet (Acipenser ruthenus) spermatozoa. Comp Biochem Physiol C Toxicol Pharmacol. 2013; 158(2): 64-71.
37. Zhou D, Yang J, Li H, Cui C, Yu Y, Liu Y, Lin K. The chronic toxicity of bisphenol A to Caenorhabditis elegans after long-term exposure at environmentally relevant concentrations. Chemosphere. 2016; 154: 546-551.
38. Lombó M, Fernández-Díez C, González-Rojo S, Herráez M.P. Genetic and epigenetic alterations induced by bisphenol A exposure during different periods of spermatogenesis: from spermatozoa to the progeny. Sci Rep. 2019; 9(1):18029.
39. Chapalamadugu KC, Vandevoort C.A, Settles M.L, Robison B.D, Murdoch G.K. Maternal bisphenol A exposure impacts the fetal heart transcriptome. PLoS One. 2014; 9(2): e89096.
40. Alavian-Ghavanini A, Lin PI, Lind P.M, Risén-Rimfors S, Halin-Lejonklou M, Dunder L, Tang M, Lindh C, Bornehag C.G, Rüegg J. Prenatal Bisphenol A Exposure is Linked to Epigenetic Changes in Glutamate Receptor Subunit Gene Grin2b in Female Rats and Humans. Sci Rep. 2018; 8(1):11315.
41. Dolinoy DC, Huang D, Jirtle R.L. Maternal nutrient supplementation counteracts bisphenol A-induced DNA hypomethylation in early development. Proc Natl Acad Sci USA. 2007; 104(32): 13056-13061.
42. Parker L. National Geographic. Canada aims to ban single-use plastics by 2021. Published in 2019. [online]
43. BBC News. Single-use plastics ban approved by European Parliament. Published in 2018. [online]
44. Lutkin A. Green Matters. India’s Prime Minister Announces Plan to Eliminate Single-Use Plastic By 2022. Published in 2019. [online]
45. National Conference of State Legislatures (NCSL). State Plastic Bag Legislation. Published in 2021. [online] https://www.ncsl.org/research/environment-and-natural-resources/plastic-bag-legislation.aspx (last accessed on September 2, 2021).
46. Philippe I. ABC news. As plastic bag bans go into effect, some question the unintended consequences. Published in 2020. [online]
47. Chung E. CBC News. Greener straws? Bacteria help turn food waste into compostable plastic. Published in 2018. [online]