Do "Forever Chemicals" Contribute to Hypertension in Women?

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1. You are a member of the healthcare team advising a large cardiology practice about potential preventive strategies for hypertension. On the basis of the prospective cohort study among middle-aged women enrolled in the Study of Women's Health Across the Nation-Multi-Pollutant Study (SWAN-MPS) by Park and colleagues, which one of the following statements about the association between serum concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) and risks of developing hypertension is correct?
   For women in the highest vs the lowest tertile of baseline serum perfluorooctane sulfonate concentration, risk for hypertension was increased by 42%
   Risk for hypertension was significantly increased for perfluorononanoate and perfluorohexane sulfonate, but not for linear perfluorooctanoate (N-PFOA) or 2-(N-ethyl-perfluorooctane sulfonamido) acetate (EtFOSAA)
   Adjustment for race, study site, education, financial strain, smoking status, alcohol use, calorie intake, and menopausal status abolished the observed associations
   In the mixture analysis, women in the highest vs the lowest tertile of overall PFAS concentrations had 22% higher risk for hypertension
2. According to the prospective cohort study among middle-aged women enrolled in SWAN-MPS by Park and colleagues, which one of the following statements about clinical and public health implications of the association between serum concentrations of PFAS and risks of developing hypertension is correct?
   The findings are easily generalizable to older men
   The study proves that PFAS cause hypertension
   The study proves that lowering PFAS exposure reduces blood pressure
   As PFAS are ubiquitous in the blood of most humans and in the environment, the findings create a significant public health concern