Plastics may be a hidden contributor to heart disease: chemical additives that disrupt hormone function and damage blood vessels. Evidence indicates that di-2-ethylhexylphthalate (DEHP)—a phthalate used to soften plastics—drives oxidative stress, metabolic dysfunction, and cardiovascular disease. A recent study found that this plastic additive may have contributed to more than 350,000 cardiovascular deaths worldwide in 2018.

To estimate the global burden of cardiovascular disease linked to DEHP exposure, researchers combined country-level cardiovascular death rates with regional exposure estimates. They calculated the number of deaths and years of life lost that were likely due to the chemical, drawing on published hazard ratios and biomonitoring data.

They found that DEHP exposure contributed to 356,000 cardiovascular deaths in 2018—around 13% of heart-related deaths among adults aged 55 to 64. Exposure varied widely by region. The Middle East and South Asia had the highest levels of several DEHP metabolites, including mono (2-ethylhexyl) phthalate at 19.460 micromoles per liter—six times higher than levels in Europe. Africa also showed high concentrations, including the highest recorded level of mono (2-ethyl-5-carboxypentyl) phthalate at 65.452 micromoles per liter. The Middle East, South Asia, and Africa bore the greatest exposure burden, while Europe had the lowest.

These findings suggest that chemical additives in plastics pose a serious threat to cardiovascular health, especially in regions with growing plastic production or weaker environmental protections. As plastic products break down, they shed tiny fragments known as microplastics, which carry considerable health risks. Learn more in this episode featuring Dr. Rhonda Patrick.