ArticleAmerican journal of physiology. Heart and circulatory physiology2017
Plastics and cardiovascular health: phthalates may disrupt heart rate variability and cardiovascular reactivity.
Article in American journal of physiology. Heart and circulatory physiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Renin-Angiotensin System Role in Cardiovascular Effects of Plasticizers: A Systematic Review.Cardiovascular toxicology · 2025Pooled it
- Systematic transcriptome-wide meta-analysis across endocrine disrupting chemicals reveals shared and unique liver pathways, gene networks, and disease associations.Environment international · 2024Pooled it
- Prenatal Dibutyl Phthalate Exposure Dysregulates Fetal-Placental Vascular Function and Placental Vasculature-Specific Lipid Metabolism.bioRxiv : the preprint server for biology · 2026Article
- Microplastics and Nanoplastics in Cardiovascular Disease: An Emerging Cardiovascular Risk Factor.Cardiovascular toxicology · 2026Review
- Exposure to phthalates and replacements during pregnancy in association with gestational blood pressure and hypertensive disorders of pregnancy.Environmental research · 2025Article
- Prenatal exposure to environmentally relevant low-dosage dibutyl phthalate reduces placental efficiency in CD-1 mice.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Sexually dimorphic cardiovascular impacts of prenatal exposure to a real-life environmental chemical mixture in adult offspring.Environmental toxicology and pharmacology · 2025Article
- Systemic investigation of di-isobutyl phthalate (DIBP) exposure in the risk of cardiovascular via influencing the gut microbiota arachidonic acid metabolism in obese mice model.Regenerative therapy · 2024Article
- Environmental chemical exposures and a machine learning-based model for predicting hypertension in NHANES 2003-2016.BMC cardiovascular disorders · 2024Article
- Bisphenol A-What Do We Know? A Global or Local Approach at the Public Health Risk Level.International journal of molecular sciences · 2024Review
- Integrative Bioinformatics-Gene Network Approach Reveals Linkage between Estrogenic Endocrine Disruptors and Vascular Remodeling in Peripheral Arterial Disease.International journal of molecular sciences · 2024Article
- The Impact of Chronic Phthalate Exposure on Rodent Anxiety and Cognition.Biological psychiatry global open science · 2024Review
- Article
- Association between urinary phthalate levels and chronic pain in US adults, 1999-2004: A nationally representative survey.Frontiers in neurology · 2023Article
- Guidelines for assessment of cardiac electrophysiology and arrhythmias in small animals.American journal of physiology. Heart and circulatory physiology · 2022Review
- Low-level plasticizer exposure and all-cause and cardiovascular disease mortality in the general population.Environmental health : a global access science source · 2022Article
- Emerging concepts and opportunities for endocrine disruptor screening of the non-EATS modalities.Environmental research · 2022Article
- Article
- Invited Perspective: Phthalates and Blood Pressure: the Unknowns of Dietary Factors.Environmental health perspectives · 2021Article
- Exposure to phthalates and cardiovascular diseases in Chinese with type 2 diabetes.Environmental science and pollution research international · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
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 have suggested that phthalate exposure adversely affects cardiovascular function. Our objective was to assess the safety and biocompatibility of phthalate chemicals and resolve the impact on cardiovascular and autonomic physiology. 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. DEHP-treated animals displayed a decrease in heart rate variability (-17% SD of normal beat-to-beat intervals and -36% high-frequency power) and an exaggerated mean arterial pressure response to ganglionic blockade (31.5% via chlorisondamine). In response to a conditioned stressor, DEHP-treated animals displayed enhanced cardiovascular reactivity (-56% SD 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. 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. Because 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.