Experimental studies have suggested that certain preservative food additives may adversely affect cardiovascular health, but human evidence has remained limited. In a large prospective cohort analysis from the French NutriNet-Santé study published in the European Heart Journal, investigators examined associations between dietary exposure to preservative additives and the incidence of hypertension and cardiovascular disease (CVD).

The NutriNet-Santé cohort enrolled participants in France between 2009 and 2024. Dietary intake was assessed using repeated 24-hour dietary records, including branded commercial food products. Investigators evaluated exposure to food preservatives using multiple food composition databases and laboratory assays performed on food matrices.

Findings

• The analysis included 112,395 participants.
• A total of 58 preservative substances consumed by at least one participant were evaluated.
• Higher intake of total non-antioxidant preservatives was associated with increased hypertension incidence (HR 1.29; 95% CI 1.20–1.39).
• Total non-antioxidant preservative exposure was also associated with higher cardiovascular disease incidence (HR 1.16; 95% CI 1.04–1.29).
• Total antioxidant preservatives were associated with increased hypertension risk (HR 1.22; 95% CI 1.13–1.31).
• During follow-up, 5,544 participants developed hypertension and 2,450 experienced cardiovascular disease events.
• Among 17 individual preservative additives consumed by at least 10% of participants, eight were associated with higher hypertension incidence after correction for multiple testing.
• One individual preservative additive was associated with higher cardiovascular disease incidence.
• The observed associations remained significant after adjustment for multiple confounding variables.

The results indicate that exposure to commonly used preservative food additives may be associated with increased risks of hypertension and cardiovascular disease in the general population.