No association between perfluoroalkyl chemicals and hypertension in children Sarah Dee Geiger,1 Jie Xiao,2 Anoop Shankar31Department of Public Health, Northern Illinois University, School of Nursing and Health Studies, DeKalb, IL, 2Registration and Records, North Carolina State University, Raleigh, NC, 3Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USABackground: Hypertension is a leading cause of cardiovascular disease worldwide. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are perfluoroalkyl chemicals (PFCs) used in the manufacture of common consumer products and detected in the blood of the majority of Americans. Emerging biological data suggest that PFC exposure may have a role in the development of hypertension. However, the association between PFCs and hypertension has not yet been explored in humans. Therefore, we examined this association in a representative sample of US children.Methods: A cross-sectional study was performed on 1,655 children from the National Health and Nutrition Examination Survey, 1999–2000 and 2003–2008. The main outcome of interest was hypertension, defined as age, height, and sex specific systolic and/or diastolic blood pressure level at the 95th percentile.Results: We found no association between serum levels of PFOA and PFOS and hypertension in either unadjusted or multivariable-adjusted analyses controlling for age, sex, race-ethnicity, body mass index, annual household income, moderate activity, total serum cholesterol, and serum cotinine. Compared with the lowest quartile, the multivariable-adjusted odds ratio (95% confidence interval) of hypertension in the highest quartile of exposure was 0.69 (0.41–1.17) for PFOA and 0.77 (0.37–1.61) for PFOS (all P-trend values >0.30).Conclusion: Our findings indicate that exposure to PFOA or PFOS is not significantly associated with hypertension in children at the lower PFC exposure levels typical of the general population.Keywords: perfluorooctanoic acid, perfluorooctane sulfonate, perfluoroalkyl chemicals, blood pressure, children