Most people know that eating too much salt can increase blood pressure. But scientists are now investigating whether other ingredients commonly added to packaged foods could also influence cardiovascular health.
A major study published in the European Heart Journal in May 2026 examined the relationship between food preservatives and the risk of developing hypertension, or high blood pressure.
Researchers analyzed dietary information from 112,395 adults in France and followed them for a median of almost eight years.
The findings revealed that people with higher intakes of several commonly used preservative additives were more likely to develop hypertension during follow-up.
Among the substances associated with higher hypertension incidence were potassium sorbate, sodium nitrite, sodium erythorbate, and citric acid used as a food additive.
Some preservative exposures were also associated with an increased incidence of cardiovascular disease.
However, the study was observational, meaning it could identify associations but could not establish whether preservatives directly caused these conditions.
The findings raise important questions about long-term exposure to food additives, but they do not prove that all preservatives or packaged foods are dangerous.
Original research: Preservative Food Additives, Hypertension, and Cardiovascular Diseases: The NutriNet-Santé Study.
Why Scientists Are Looking Beyond Salt
High blood pressure is one of the most important preventable risk factors for cardiovascular disease.
When blood pressure remains elevated over time, it can damage blood vessels and increase the risk of heart attack, stroke, heart failure, and kidney disease.
Excess dietary sodium contributes to high blood pressure.
According to the World Health Organization (WHO), adults should consume less than 2,000 milligrams of sodium daily, about 5 grams of salt.
However, packaged foods contain more sodium.
Many also include preservatives designed to prevent microbial growth, slow chemical deterioration, maintain color, or protect food quality.
These additives serve important functions. By reducing spoilage and contamination, preservatives can help improve food safety and extend shelf life.
Nevertheless, researchers are investigating whether repeated exposure to certain additives could have previously unrecognized long-term health implications.
The 2026 NutriNet-Santé study provides new epidemiological evidence relevant to this question.
Source: WHO Sodium Reduction, updated May 2026.
What Are Food Preservatives?
Food preservatives are substances added to foods to slow spoilage or maintain desirable qualities during storage.
They work through different mechanisms.
Some limit the growth of bacteria, molds, and yeasts.
Others slow oxidation, a chemical process that can make food fats rancid or affect food color and flavor.
Food preservatives fall into two broad functional categories.
Non-Antioxidant Preservatives
These additives primarily slow microbial spoilage or support food stability.
Examples include:
- Potassium sorbate (E202).
- Sodium nitrite (E250).
- Potassium metabisulphite (E224).
- Certain benzoates and propionates.
Antioxidant Preservatives
These additives help protect food ingredients from oxidation.
Examples include:
- Ascorbic acid (E300).
- Sodium ascorbate (E301).
- Sodium erythorbate (E316).
- Certain tocopherols and other antioxidant compounds.
Some substances can occur naturally in foods and can also be added during manufacturing.
For example, citric acid naturally occurs in citrus fruits but is also widely used as an acidity regulator and preservative-related food additive.
Likewise, ascorbic acid is another name for vitamin C, an essential nutrient.
A chemical’s presence on an ingredient label does not automatically mean that the food is unsafe.
The amount consumed, the substance’s intended function, the overall diet, and the strength of the available evidence all matter.
The US Food and Drug Administration explains that preservatives help protect foods against spoilage, oxidation, and contamination.
Source: FDA Food Additives and GRAS Ingredients.
What Was the 2026 NutriNet-Santé Study?
The research was conducted by a team led by Anaïs Hasenböhler and colleagues.
The investigators used data from the NutriNet-Santé study, an ongoing French research cohort established to examine relationships between nutrition and health.
The analysis included 112,395 adults, approximately 78.7% of whom were women.
Participants averaged 42.8 years at the time of characterization for this analysis.
Dietary and health information covered 2009 through 2024.
Researchers followed participants for a median of 7.9 years.
During the study, participants completed repeated 24-hour dietary records.
Unlike a simple food-frequency questionnaire, these records asked participants to describe the foods and beverages they consumed on specific days.
Researchers also collected information about commercial brands to estimate exposure to specific additives used in industrial food products.
The team combined dietary data with food composition databases and laboratory analyses to estimate preservative intake.
They identified 58 preservative substances consumed by at least one participant.
Seventeen preservatives were consumed by at least 10% of participants and were examined individually in the main analyses.
The researchers then investigated whether higher preservative intake was associated with newly diagnosed hypertension or cardiovascular disease.
What Did the Researchers Discover?
During follow-up, investigators identified:
- 5,544 new cases of hypertension.
- 2,450 cardiovascular disease events, including coronary heart disease and cerebrovascular events.
The analysis accounted for numerous potential confounders, including participants’ diet and lifestyle.
Even after statistical adjustments, several preservative exposures remained associated with a higher incidence of hypertension.
The results were particularly notable for non-antioxidant preservatives.
1. Higher Non-Antioxidant Preservative Intake Was Linked to Greater Hypertension Risk
Participants with higher total intakes of non-antioxidant preservatives had a 29% higher relative hazard of developing hypertension compared with those with lower intakes.
The reported hazard ratio was 1.29.
A hazard ratio compares the rate at which an event occurs during follow-up between groups.
A value above 1 indicates a higher observed event rate in the exposed group.
Importantly, a 29% higher relative hazard does not mean that 29 out of every 100 consumers will develop hypertension.
It also does not prove that reducing preservatives would lower a person’s blood pressure by 29%.
The same preservative category was associated with a 16% higher relative hazard of cardiovascular disease.
These associations remained after adjustment for several measured risk factors, but unmeasured differences between participants may still have influenced the findings.
2. Antioxidant Preservatives Were Also Associated With Hypertension
One unexpected finding involved additives commonly used to protect foods from oxidation.
Participants with higher total antioxidant preservative exposure had a 22% higher relative hazard of developing hypertension.
This does not mean antioxidants are universally harmful.
Antioxidants include many different substances with different biological functions.
The finding specifically concerns estimated intake of antioxidant compounds used as food additives in the studied population.
It should not be generalized to naturally occurring antioxidants in fruits and vegetables.
Nor does it establish that eating foods containing vitamin C increases blood pressure.
Which Preservatives Were Most Strongly Associated With Hypertension?
The study identified associations involving several individual additives.
The following table summarizes selected results after adjustment for measured confounding factors and correction for multiple statistical comparisons.
| Food additive | European code | Higher relative hazard of hypertension |
| Potassium sorbate | E202 | 39% |
| Citric acid | E330 | 25% |
| Potassium metabisulphite | E224 | 16% |
| Sodium nitrite | E250 | 16% |
| Sodium erythorbate | E316 | 14% |
| Ascorbic acid | E300 | 14% |
| Sodium ascorbate | E301 | 12% |
| Rosemary extracts | E392 | 10% |
These percentages describe adjusted relative hazard associations between higher and lower exposure groups. They do not measure increases in blood pressure or demonstrate causation.
Source: European Heart Journal, Full Study Results.
Potassium Sorbate: The Strongest Individual Association
Potassium sorbate is commonly used to inhibit molds and yeasts.
It may be found in certain baked goods, cheeses, sauces, beverages, and other processed products.
The researchers found that participants with higher potassium sorbate exposure had a 39% higher relative hazard of developing hypertension compared with lower-exposure participants.
The reported hazard ratio was 1.39, with a 95% confidence interval of 1.28 to 1.50.
This was among the strongest associations observed for an individual preservative.
However, the study did not show that potassium sorbate directly damages blood vessels or that avoiding it prevents hypertension.
People who regularly consume products containing potassium sorbate may differ in other ways from those who consume less.
For example, their overall dietary patterns, food choices, and long-term health behaviors may influence cardiovascular risk.
Although researchers attempted to account for these factors, observational studies cannot eliminate every possible source of confounding.
The finding is therefore a reason for further investigation, not definitive proof of harm.
Sodium Nitrite: Why Processed Meat Matters
Some cured and processed meat products contain sodium nitrite.
It helps preserve color, contributes to product characteristics, and can inhibit the growth of dangerous microorganisms.
In the NutriNet-Santé analysis, higher exposure to sodium nitrite was associated with a 16% higher relative hazard of hypertension.
Researchers found that processed meats were a major source of nitrite exposure in the cohort.
This finding adds to broader concerns surrounding frequent consumption of certain processed meat products.
However, processed meats differ in sodium content, fat composition, preparation methods, and other ingredients.
The study therefore cannot determine whether sodium nitrite itself, other components of processed meat, or a combination of factors caused the observed relationship.
The results also should not be used to suggest that manufacturers remove food-safety preservatives without validating safe alternatives.
Nitrites serve important food-preservation functions, and reformulating products requires careful safety assessment.
Citric Acid and Vitamin C: Why the Results Need Context
Two of the most widely consumed additive substances in the study were citric acid and ascorbic acid.
Citric acid, listed as E330 in European food labeling, was associated with a 25% higher relative hazard of hypertension among participants with higher estimated additive exposure.
Ascorbic acid, or vitamin C, was associated with a 14% higher relative hazard of hypertension and a 15% higher relative hazard of cardiovascular disease.
At first glance, this might seem surprising.
Vitamin C is an essential nutrient, and fruits and vegetables containing vitamin C are widely recommended as part of healthy dietary patterns.
The distinction is that the research examined estimated exposure to compounds used as additives within particular foods.
It did not demonstrate that naturally occurring vitamin C or citric acid in whole foods causes hypertension.
The same chemical may appear in very different dietary contexts.
For example, eating an orange is not nutritionally equivalent to consuming a highly processed beverage containing added citric acid.
The surrounding foods, their nutrient composition, and overall dietary patterns can differ substantially.
The results should not discourage people from eating citrus fruits, vegetables, or other foods naturally rich in vitamin C.
Do Preservatives Directly Cause High Blood Pressure?
This remains unanswered.
The researchers observed associations between preservative intake and subsequent diagnoses of hypertension.
Because participants were followed over time, the study provides stronger information about the sequence of exposure and disease than a one-time survey.
However, prospective observational studies cannot establish causation on their own.
Several possible explanations account for the associations.
Certain preservatives might influence biological pathways relevant to blood pressure.
Alternatively, preservative exposure may act as a marker for other characteristics of industrial food consumption.
Both explanations may contribute.
Researchers have proposed mechanisms involving inflammation, oxidative stress, vascular function, and the gut microbiome.
But these mechanisms were not directly established as the explanation for the observed associations in this cohort.
The authors specifically called for additional experimental research to clarify the biological processes involved.
Future studies will need to determine whether individual additives have direct effects at typical dietary exposure levels.
Were Cardiovascular Diseases Also Linked to Preservatives?
Yes, although the findings were less extensive than those for hypertension.
Higher overall intake of non-antioxidant preservatives was associated with a 16% higher relative hazard of cardiovascular disease.
The researchers also found an association between higher exposure to ascorbic acid additives and cardiovascular disease.
However, most individual preservative associations with cardiovascular outcomes were not statistically significant after correction for multiple comparisons.
This matters because testing numerous additives against several health outcomes increases the chance of identifying apparently significant results by chance.
Correcting for multiple comparisons helps reduce that problem.
The authors also investigated mixtures of additives commonly consumed together.
Some mixtures were associated with hypertension, but none of the three identified mixtures showed a statistically significant association with the cardiovascular disease outcomes evaluated.
The evidence therefore supports further study of preservatives and blood pressure, rather than a sweeping conclusion that these additives cause heart disease.
What Are the Limitations of This Research?
Despite its large size and detailed dietary assessment, the study has several important limitations.
1. It Was Observational
Researchers did not randomly assign participants to different preservative doses.
Therefore, the study cannot establish that preservatives caused hypertension or cardiovascular disease.
2. Participants Were Not Fully Representative of the General Population
The NutriNet-Santé cohort consisted of volunteers in France.
Women made up nearly 79% of participants.
Volunteer research cohorts can differ from the wider population in education, health awareness, dietary habits, and other characteristics.
Consequently, the findings may not apply equally to every country or population.
3. Preservative Exposure Was Estimated
Researchers combined detailed dietary records with food databases and laboratory measurements.
Nevertheless, researchers did not directly measure the exact quantity of additives in every product each participant consumed.
Food manufacturing practices can also change over time.
Exposure estimates therefore involve some uncertainty.
4. Packaged Foods Contain Many Ingredients
Foods containing preservatives may also contain significant quantities of sodium, refined carbohydrates, added sugars, or other additives.
Statistical adjustment helps address these differences but cannot guarantee that it removes all confounding.
5. The Study Did Not Test Whether Avoiding Preservatives Lowers Blood Pressure
A critical unanswered question is whether deliberately reducing intake of specific additives would improve blood pressure or reduce cardiovascular events.
Randomized intervention studies would provide stronger evidence.
6. Individual Risk Cannot Be Predicted From the Reported Percentages
The reported hazard ratios describe differences between exposure groups within the studied population.
They cannot predict whether a particular individual will develop hypertension or how many blood pressure points an additive might increase.
October 2026 Update: Why These Findings Matter
The paper first appeared online in May 2026 and was subsequently included in the October 14, 2026 issue of the European Heart Journal.
Its findings contribute to a growing discussion about whether food additive safety assessments should consider long-term chronic disease outcomes in addition to established toxicological endpoints.
Importantly, the researchers noted that participants generally did not exceed established acceptable daily intake levels for several evaluated preservatives.
That observation raises a scientific question about whether existing assessments adequately capture all possible long-term outcomes.
However, the study alone does not demonstrate that current regulatory limits are unsafe.
Food additives undergo safety evaluation, and authorized preservatives also play an important role in preventing spoilage and foodborne illness.
The appropriate scientific response is additional research and regulatory review where warranted—not assuming that every chemical-sounding ingredient is hazardous.
The US FDA explains that additive safety decisions depend on evidence about the substance, intended use, expected exposure, and other relevant factors.
Source: FDA, Understanding How Food Additives Are Regulated.
What Can Consumers Do to Protect Their Heart Health?
While research into preservative additives continues, several well-established dietary strategies can help support cardiovascular health.
1. Reduce Excess Sodium
Excessive sodium intake is strongly linked a higher blood pressure.
The WHO recommends less than 2,000 milligrams of sodium per day for adults.
Checking nutrition labels helps you identify high-sodium products.
2. Choose More Minimally Processed Foods
Build more meals around vegetables, fruits, beans, lentils, whole grains, nuts, and other nutrient-rich foods.
These foods can form the foundation of a heart-healthy eating pattern.
This does not mean every packaged food is unhealthy.
Plain frozen vegetables, canned beans with no added salt, and other minimally processed convenience foods can also be useful options.
3. Compare Ingredient Lists and Nutrition Labels
When buying packaged foods, compare sodium levels, serving sizes, and overall nutritional quality.
Ingredient lists can also identify additives used in different products.
However, shorter ingredient lists do not automatically guarantee better nutritional quality or safety.
4. Limit Frequent Consumption of Processed Meats
Processed meats can contribute substantial sodium and may contain nitrite or nitrate preservatives.
Choosing less processed protein sources more often can support a healthier dietary pattern.
5. Avoid Overreacting to Individual Additives
The research does not justify eliminating all foods containing citric acid, vitamin C, or potassium sorbate.
Food safety, affordability, nutritional value, and practicality all matter.
The goal should be to improve overall diet quality rather than treat every preservative as a confirmed health threat.
6. Monitor Your Blood Pressure
High blood pressure often causes no noticeable symptoms.
People with elevated readings or established hypertension should follow medical advice about monitoring, lifestyle changes, and prescribed treatment.
Dietary improvements matter, but they don’t replace necessary blood pressure medication.
Conclusion: Important Evidence, but Not Proof of Harm
The 2026 NutriNet-Santé study provides important new evidence about the potential relationship between food preservative additives and cardiovascular health.
After examining dietary data from more than 112,000 adults, researchers identified associations between higher exposure to certain preservatives and an increased incidence of hypertension.
Potassium sorbate, citric acid, sodium nitrite, and several other substances were among the additives linked to elevated relative hazards.
However, the findings do not prove that these chemicals directly cause high blood pressure.
Additional research is needed to determine whether the associations reflect direct biological effects, broader dietary patterns, or other factors.
For consumers, the most practical conclusion is not to fear every ingredient on a package.
Instead, prioritizing a balanced diet, limiting excess sodium, choosing nutritious foods, and monitoring blood pressure remain evidence-based ways to protect cardiovascular health.
The study also highlights why continued scientific evaluation of food additive exposure is important as dietary habits and food manufacturing practices evolve.
References
1. Original Research Study (2026)
Hasenböhler, A., Javaux, G., Payen de la Garanderie, M., et al. Preservative Food Additives, Hypertension, and Cardiovascular Diseases: The NutriNet-Santé Study. European Heart Journal, 47(39), 5788–5804.
https://doi.org/10.1093/eurheartj/ehag308
2. Open-Access Full Research Paper
PubMed Central, US National Library of Medicine.
https://pmc.ncbi.nlm.nih.gov/articles/PMC13690824
3. PubMed Research Record
National Library of Medicine.
https://pubmed.ncbi.nlm.nih.gov/42161430
4. World Health Organization (2026)
Sodium Reduction.
https://www.who.int/news-room/fact-sheets/detail/sodium-reduction
5. American Heart Association (2026)
Dietary Guidance to Improve Cardiovascular Health.
https://doi.org/10.1161/CIR.0000000000001435
6. US Food and Drug Administration
Food Additives and GRAS Ingredients: Information for Consumers.
7. US Food and Drug Administration
Understanding How the FDA Regulates Food Additives and GRAS Ingredients.
8. American Heart Association
How Much Sodium Should I Eat Per Day?