title: Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50: a longitudinal birth cohort study.
abstract: BACKGROUND
  Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment.
  
  
  OBJECTIVE
  We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension.
  
  
  METHODS
  We examined concentrations of DDT (p,p´- and o,p´-) and its metabolite p,p´-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39-47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures.
  
  
  RESULTS
  Prenatal p,p´-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p´-DDT relative to the lowest tertile, respectively]. These associations between p,p´-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses.
  
  
  CONCLUSIONS
  These findings suggest that the association between DDT exposure and hypertension may have its origins early in development.
authors.affiliation: Department of Environmental Toxicology, University of California, Davis, Davis, California 95616-5270, USA. mlamerrill@ucdavis.edu
authors.forename: Michele
authors.initials: M
authors.lastname: La Merrill
authors.forename: Piera M
authors.initials: PM
authors.lastname: Cirillo
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
authors.forename: Nickilou Y
authors.initials: NY
authors.lastname: Krigbaum
authors.forename: Julie D
authors.initials: JD
authors.lastname: Flom
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cohn
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003634:DDT / Q000633:toxicity*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology; D008137:Longitudinal Studies; D018811:Maternal Exposure / Q000009:adverse effects*; D008875:Middle Aged; D010575:Pesticides / Q000633:toxicity*; D011247:Pregnancy; D016016:Proportional Hazards Models; D012044:Regression Analysis
chemical_list: D010575:Pesticides; D003634:DDT