Published In

JAMA Cardiology

Document Type

Article

Publication Date

1-2019

Subjects

Cardiovascular system -- Diseases -- Risk factors

Abstract

IMPORTANCE It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

OBJECTIVE To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

DESIGN, SETTING, AND PARTICIPANTS This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February 2016). Participants without cardiovascular disease at baseline were included. Data were analyzed from June 2017 to September 2018. EXPOSURES A panel of several established cardiovascular risk factors. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) per 1-SD higher usual risk factor levels (or presence/absence). Incident fatal outcomes in ERFC (VTE, 1041; coronary heart disease [CHD], 25 131) and incident fatal/nonfatal outcomes in UK Biobank (VTE, 2321; CHD, 3385). Hazard ratioswere adjusted for age, sex, smoking status, diabetes, and body mass index (BMI). RESULTS Of the 731 728 participants from the ERFC, 403 396 (55.1%)were female, and the mean (SD) age at the time of the survey was 51.9 (9.0) years; of the 421 537 participants from the UK Biobank, 233 699 (55.4%)were female, and the mean (SD) age at the time of the surveywas 56.4 (8.1) years. Risk factors forVTE included older age (ERFC:HRper decade, 2.67; 95%CI, 2.45-2.91; UKBiobank:HR, 1.81; 95%CI, 1.71-1.92), current smoking (ERFC:HR, 1.38; 95%CI, 1.20-1.58;UK Biobank:HR,1.23;95%CI,1.08-1.40),andBMI(ERFC:HRper1-SD higher BMI,1.43;95%CI,1.35-1.50; UK Biobank:HR, 1.37; 95%CI, 1.32-1.41). For these factors, there were similar HRs for pulmonary embolism and deep vein thrombosis inUKBiobank(except a diposity was more strongly associated with pulmonary embolism) and similar HR sforun provokedvs provokedVTE.Apart from a diposity, these risk factors were less strongly associated with VTE than CHD. There were inconsistent associations ofVTEs with diabetes and blood pressure across ERFC andUK Biobank, and there was limited ability to study lipid and inflammation markers.

CONCLUSIONS AND RELEVANCE Older age, smoking, and adipositywere consistently associated with higher VTE risk.

Description

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DOI

10.1001/jamacardio.2018.4537

Persistent Identifier

https://archives.pdx.edu/ds/psu/28942

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