Association of traditional cardiovascular risk factors with venous thromboembolism
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Association of traditional cardiovascular risk factors with venous thromboembolism. / Mahmoodi, Bakhtawar K.; Cushman, Mary; Næss, Inger Anne; Allison, Matthew A.; Bos, Willem Jan; Brækkan, Sigrid K.; Cannegieter, Suzanne C.; Gansevoort, Ron T.; Gona, Philimon N.; Hammerstrøm, Jens; Hansen, John Bjarne; Heckbert, Susan; Holst, Anders G.; Lakoski, Susan G.; Lutsey, Pamela L.; Manson, Jo Ann E.; Martin, Lisa W.; Matsushita, Kunihiro; Meijer, Karina; Overvad, Kim; Prescott, Eva; Puurunen, Marja; Rossouw, Jacques E.; Sang, Yingying; Severinsen, Marianne T.; Ten Berg, Jur; Folsom, Aaron R.; Zakai, Neil A.
I: Circulation, Bind 135, Nr. 1, 2017, s. 7-16.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Association of traditional cardiovascular risk factors with venous thromboembolism
AU - Mahmoodi, Bakhtawar K.
AU - Cushman, Mary
AU - Næss, Inger Anne
AU - Allison, Matthew A.
AU - Bos, Willem Jan
AU - Brækkan, Sigrid K.
AU - Cannegieter, Suzanne C.
AU - Gansevoort, Ron T.
AU - Gona, Philimon N.
AU - Hammerstrøm, Jens
AU - Hansen, John Bjarne
AU - Heckbert, Susan
AU - Holst, Anders G.
AU - Lakoski, Susan G.
AU - Lutsey, Pamela L.
AU - Manson, Jo Ann E.
AU - Martin, Lisa W.
AU - Matsushita, Kunihiro
AU - Meijer, Karina
AU - Overvad, Kim
AU - Prescott, Eva
AU - Puurunen, Marja
AU - Rossouw, Jacques E.
AU - Sang, Yingying
AU - Severinsen, Marianne T.
AU - Ten Berg, Jur
AU - Folsom, Aaron R.
AU - Zakai, Neil A.
PY - 2017
Y1 - 2017
N2 - Background: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). Methods: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines. Estimates were obtained for overall VTE, provoked VTE (ie, VTE occurring in the presence of 1 or more established VTE risk factors), and unprovoked VTE, pulmonary embolism, and deep-vein thrombosis. Results: The studies included 244 865 participants with 4910 VTE events occurring during a mean follow-up of 4.7 to 19.7 years per study. Age, sex, and body mass index-adjusted hazard ratios for overall VTE were 0.98 (95% confidence interval [CI]: 0.89-1.07) for hypertension, 0.97 (95% CI: 0.88-1.08) for hyperlipidemia, 1.01 (95% CI: 0.89-1.15) for diabetes mellitus, and 1.19 (95% CI: 1.08-1.32) for current smoking. After full adjustment, these estimates were numerically similar. When modeled continuously, an inverse association was observed for systolic blood pressure (hazard ratio=0.79 [95% CI: 0.68-0.92] at systolic blood pressure 160 vs 110 mm Hg) but not for diastolic blood pressure or lipid measures with VTE. An important finding from VTE subtype analyses was that cigarette smoking was associated with provoked but not unprovoked VTE. Fully adjusted hazard ratios for the associations of current smoking with provoked and unprovoked VTE were 1.36 (95% CI: 1.22-1.52) and 1.08 (95% CI: 0.90-1.29), respectively. Conclusions: Except for the association between cigarette smoking and provoked VTE, which is potentially mediated through comorbid conditions such as cancer, the modifiable traditional cardiovascular disease risk factors are not associated with increased VTE risk. Higher systolic blood pressure showed an inverse association with VTE.
AB - Background: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). Methods: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines. Estimates were obtained for overall VTE, provoked VTE (ie, VTE occurring in the presence of 1 or more established VTE risk factors), and unprovoked VTE, pulmonary embolism, and deep-vein thrombosis. Results: The studies included 244 865 participants with 4910 VTE events occurring during a mean follow-up of 4.7 to 19.7 years per study. Age, sex, and body mass index-adjusted hazard ratios for overall VTE were 0.98 (95% confidence interval [CI]: 0.89-1.07) for hypertension, 0.97 (95% CI: 0.88-1.08) for hyperlipidemia, 1.01 (95% CI: 0.89-1.15) for diabetes mellitus, and 1.19 (95% CI: 1.08-1.32) for current smoking. After full adjustment, these estimates were numerically similar. When modeled continuously, an inverse association was observed for systolic blood pressure (hazard ratio=0.79 [95% CI: 0.68-0.92] at systolic blood pressure 160 vs 110 mm Hg) but not for diastolic blood pressure or lipid measures with VTE. An important finding from VTE subtype analyses was that cigarette smoking was associated with provoked but not unprovoked VTE. Fully adjusted hazard ratios for the associations of current smoking with provoked and unprovoked VTE were 1.36 (95% CI: 1.22-1.52) and 1.08 (95% CI: 0.90-1.29), respectively. Conclusions: Except for the association between cigarette smoking and provoked VTE, which is potentially mediated through comorbid conditions such as cancer, the modifiable traditional cardiovascular disease risk factors are not associated with increased VTE risk. Higher systolic blood pressure showed an inverse association with VTE.
KW - cardiovascular disease
KW - diabetes mellitus
KW - hyperlipidemia
KW - hypertension
KW - risk factors
KW - smoking
KW - venous thromboembolism
U2 - 10.1161/CIRCULATIONAHA.116.024507
DO - 10.1161/CIRCULATIONAHA.116.024507
M3 - Journal article
C2 - 27831499
AN - SCOPUS:84996866012
VL - 135
SP - 7
EP - 16
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 1
ER -
ID: 189699985