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Smoking, obesity, older age predict increased VTE risk
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Older age, smoking and obesity were consistently associated with increased risk for venous thromboembolism, according to a study published in JAMA Cardiology.
The study, conducted by John Gregson, PhD, of the department of medical statistics at the London School of Hygiene and Tropical Medicine in England, and colleagues, sought to estimate the associations of major CV risk factors with VTE, defined as deep vein thrombosis or pulmonary embolism.
“In recent years, efforts to prevent VTE have broadened from focusing mainly on hospital-based risk factors ... toward adoption of heart-healthy lifestyles,” Gregson and colleagues wrote. “However, there is uncertainty about the extent to which venous and arterial thrombosis share cardiovascular risk factors, as studies have reported conflicted findings.”
The study consisted of 731,728 participants from 75 cohorts in the Emerging Risk Factors Collaboration (ERFC), ranging from February 1960 to June 2008 (mean age, 52 years; 55% women), and 421,537 participants from the UK Biobank study (mean age, 56 years; 55% women) with a median follow-up of 15 years. The primary outcomes were incident fatal outcomes in ERFC and incident fatal/nonfatal outcomes in UK Biobank, with HRs adjusted for age, sex, smoking status, diabetes and BMI.
Risk factors for VTE included older age (HR per decade = 2.67; 95% CI, 2.45-2.91 for ERFC; HR per decade = 1.81; 95% CI, 1.71-1.92 for UK Biobank), current smoking (HR = 1.38; 95% CI, 1.2-1.58 for ERFC; HR = 1.23; 95% CI, 1.08-1.4 for UK Biobank) and BMI (HR per 1-standard deviation higher BMI = 1.43; 95% CI, 1.35-1.5 for ERFC; HR per 1-standard deviation BMI = 1.37; 95% CI, 1.32-1.41 for UK Biobank).
There were similar hazard ratios for PE and DVT in UK Biobank except for obesity, which was more strongly associated with PE, and similar hazard ratios for unprovoked vs. provoked VTE, Gregson and colleagues wrote. Apart from obesity, the risk factors were less strongly associated with VTE than CHD.
The researchers also identified inconsistent associations of VTEs with diabetes and BP across both cohorts. In addition, they wrote, the ability to study lipid and inflammation markers was limited.
“There is an overlap in at least some of the major population determinants of important venous and arterial thrombotic diseases,” Gregson and researchers wrote. – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.
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