Persistent Organic Pollutants and Heart Rate Variability: A Population-Based Cross-Sectional Study in China

Emerging evidence has suggested that persistent organic pollutants (POPs) are linked with cardiovascular disease. However, limited evidence has systematically investigated the association between different types of POPs, individually or as mixtures, and heart rate variability (HRV).

In a community of 159 Chinese adults, we measured the serum concentrations of 100 POPs and assessed 7 HRV indicators. Single-pollutant-based robust linear regression and the least absolute shrinkage and selection operator regression were applied to identify significant POP-HRV pairs. Weighted quantile sum and Bayesian kernel machine regression models were used to assess the joint associations of POPs overlapping.

Propetamphos, phosalone, metolachlor, and hexachlorobenzene were consistently associated with HRV indicators in both single-pollutant and least absolute shrinkage and selection operator models (all false discovery rate <0.2). One ln-unit increase of propetamphos was related with a 19.25% (95% CI: 6.83%, 30.02%) decrease in the root mean square successive difference (r-MSSD) and 20.08% (95% CI: 7.92%, 30.6%) decrease in very high frequency. However, p1 ln-unit increase of hexachlorobenzene was associated with a 35.17% (95% CI: 13.39%, 61.14%) and 31.21% (95% CI: 9.72%, 56.91%) increase in r-MSSD and very high frequency. Mixture analyses presented that co-exposure to POPs was associated with the lower value of r-MSSD and very high frequency, dominated by propetamphos.

This exploratory study suggested that POPs exposure might be linked to changes in HRV, with propetamphos as a potential key driver. The preliminary findings fill a knowledge gap concerning complex mixtures and offer a theoretical basis for future research into POPs exposure management and cardiovascular disease prevention.