Association of organophosphate and pyrethroid pesticide metabolites and phenoxyacid herbicides with blood pressure and hypertension among older adults

Previous studies suggest an association between pesticide exposure and elevated blood pressure, but have focused on occupationally exposed populations or the general population. Older adults represent a vulnerable population with potentially heightened susceptibility to pesticide exposure and more complex health management requirements due to age-related physiological changes. In this study, we investigated the association of organophosphate and pyrethroid pesticide metabolites and phenoxyacid herbicides with blood pressure and hypertension in 360 older adults from the Guangzhou community-based health management services program. A significant positive association was observed between ln para-nitrophenol and hypertension (odds ratio: 1.08, 95 % CI: 1.02–1.48, P = 0.03) after false discovery rate correction. We observed sex-specific associations of pesticide metabolites with hypertension and blood pressure. Specifically, sex-stratified logistic models indicated that 2,4-dichlorophenoxyacetic acid was associated with higher hypertension risk in males. Restricted cubic spline analyses demonstrated stronger and non-linear patterns of associations of 3-phenoxybenzoic acid and trans -3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid with hypertension risk in females, while these associations in males were weak or non-significant. Bayesian Kernel Machine Regression revealed significant positive joint effects of pesticide metabolites on hypertension and systolic blood pressure. Para-nitrophenol and 2,4-dichlorophenoxyacetic acid were identified as the most significant pesticide metabolites that contributed to elevated hypertension risk and systolic blood pressure, respectively. Sex-stratified analyses confirmed the presence of joint effects of pesticide metabolites on hypertension in both males and females, with substantially stronger associations observed among females. The study demonstrated the associations of pesticide exposure with hypertension and blood pressure in older adults, suggesting that routine pesticide biomonitoring should be implemented to identify this potentially overlooked risk factor for more comprehensive cardiovascular health risk assessment. • Pesticide exposure is associated with blood pressure in older adults. • BKMR analysis highlighted cumulative pesticide effects on blood pressure. • Sex-specific associations between urinary pesticide metabolites and hypertension. • Para-nitrophenol and 2,4-DCA were key contributors to hypertension risk.