Common food preservatives were tied to a 29% higher risk of high blood pressure

Adults who ate the most non-antioxidant preservatives in a large French cohort developed high blood pressure 29% more often than those who ate the least. The same group showed a 16% higher rate of cardiovascular disease, and the association held after the analysis accounted for age, lifestyle and diet. Mathilde Touvier of INSERM, the senior author, says the results should prompt regulators to look again at how these additives are assessed.

The work comes from NutriNet-Santé, a web-based cohort run by Sorbonne Paris Nord University, INSERM and other French institutions, and was published in the European Heart Journal in May 2026 before the European Society of Cardiology pushed it out to a wider audience in September. It is an observational study. It shows that the two things travel together, not that the additives cause the disease.

NutriNet-Santé cohort and the 29% figure

Preservatives sit in a large share of packaged food.

The analysis covered 112,395 adults, with a mean age near 42 and about 79% of them women, followed for a median of 7.9 years. According to the journal’s abstract, 5,544 participants developed hypertension and 2,450 had a cardiovascular event over that period. Exposure was built from repeated 24-hour dietary records, up to 96 per person, matched to commercial brand information so that the preservatives in specific products could be counted rather than guessed.

Participants in the top band of non-antioxidant preservative intake had a 29% higher incidence of hypertension than those in the bottom band, and a 16% higher incidence of cardiovascular disease. Antioxidant preservatives, a separate class, were associated with a 22% higher hypertension incidence, as the European Society of Cardiology summary reports. The 29% describes the class of non-antioxidant preservatives as a whole, not any one additive, and it compares the highest consumers with the lowest, not an average eater with a non-eater.

The eight additives tied to hypertension

The paper does not rank products or tell shoppers what to drop. What it supplies is a map of which additives, among the ones people actually eat in France, moved with blood pressure after other risk factors were set aside. That map is the part of the work most likely to be tested next, because each of the eight has a different chemistry, a different set of foods it turns up in, and a different regulatory limit in the European Union, so a confirmed signal for one would not automatically implicate the rest, and a null result for another would not clear the whole group.

Among the 17 preservatives eaten widely enough to analyse individually, eight were linked to higher hypertension risk: potassium sorbate (E202), potassium metabisulphite (E224), sodium nitrite (E250), ascorbic acid (E300), sodium ascorbate (E301), sodium erythorbate (E316), citric acid (E330) and rosemary extract (E392). The INSERM and ESC release singles out ascorbic acid as the one also connected with cardiovascular disease.

The list includes compounds that people tend to read as benign, such as citric acid and an extract of rosemary. The study does not say those substances are harmful at the doses in a normal diet. It says that higher exposure, as logged through industrial products, tracked with more cases. Exposure was also near-universal: according to the American College of Cardiology’s journal scan, 99.5% of participants consumed at least one preservative within their first two years in the study.

Oxidative stress, the pancreas and what the design cannot show

Touvier points to earlier experimental work for a plausible route. “Experimental research in the literature consistently suggested that preservatives may cause oxidative stress in the body or affect the way the pancreas works,” she said. Oxidative stress and disturbed glucose regulation are both established contributors to vascular damage, so the hypothesis is coherent. The team says later work will examine inflammation, gut microbiota and metabolic profiles, which would show whether the effect runs through the vessels, the gut or the way the body handles sugar, and whether it differs between the additives that were flagged.

The limits are written into the paper. The ESC summary states that the study identified statistical associations rather than proving that preservatives were directly responsible, and the authors say the findings need confirmation in other cohorts and in experiments. The volunteers were mostly women who signed up to a nutrition study, so the sample is not a mirror of the French population, and that can distort comparisons. Diet records can also miss additives that appear in a product under a different name, and people who eat many preserved foods tend to differ from other eaters in ways that no adjustment fully captures.

The study’s recommendation is modest and aimed at institutions. Touvier’s team asks agencies to re-evaluate the risks and benefits of these additives and advises eating more minimally processed food. The NutriNet-Santé project continues to enrol and follow volunteers, and it is the follow-up of that cohort, not a single paper, that will show whether the 29% holds as more years and more hypertension cases accumulate.

This article was produced with the assistance of AI and reviewed by Morning Overview editors prior to publication.

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