To cite this article: Naess IA, Christiansen SC, Romundstad P, Cannegieter SC, Rosendaal FR, Hammerstrøm J. Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost 2007; 5: 692-9.See also Sørensen HT. Venous thromboembolism and the concepts of the incidence and mortality. This issue, pp 690-1.Summary. Background: Estimates of the incidence of venous thrombosis (VT) vary, and data on mortality are limited. Objectives: We estimated the incidence and mortality of a first VT event in a general population. Methods: From the residents of Nord-Trøndelag county in Norway aged 20 years and older (n = 94 194), we identified all cases with an objectively verified diagnosis of VT that occurred between 1995 and 2001. Patients and diagnosis characteristics were retrieved from medical records. Results: Seven hundred and forty patients were identified with a first diagnosis of VT during 516 405 personyears of follow-up. The incidence rate for all first VT events was 1.43 per 1000 person-years [95% confidence interval (CI): 1.33-1.54], that for deep-vein thrombosis (DVT) was 0.93 per 1000 person-years (95% CI: 0.85-1.02), and that for pulmonary embolism (PE) was 0.50 per 1000 person-years (95% CI: 0.44-0.56). The incidence rates increased exponentially with age, and were slightly higher in women than in men. The 30-day casefatality rate was higher in patients with PE than in those with DVT [9.7% vs. 4.6%, risk ratio 2.1 (95% CI: 1.2-3.7)]; it was also higher in patients with cancer than in patients without cancer [19.1% vs. 3.6%, risk ratio 3.8 (95% CI 1.6-9.2)]. The risk of dying was highest in the first months subsequent to the VT, after which it gradually approached the mortality rate in the general population. Conclusions: This study provides estimates of incidence and mortality of a first VT event in the general population.

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Background There is much controversy surrounding the association of traditional cardiovascular disease (CVD) risk factors with venous thromboembolism (VTE). Methods We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline CVD risk factors and validated VTE events. Definitions were harmonized across studies. Traditional CVD risk factors were modeled categorically, as well as continuously using restricted cubic splines. Estimates were obtained for overall VTE, provoked (i.e., VTE occurring in the presence of one or more established VTE risk factors) and unprovoked VTE, pulmonary embolism (PE) and deep-vein thrombosis (DVT). Results The studies included 244,865 participants with 4,910 VTE events occurring during a mean follow-up 4.7–19.7 years per study. Age, sex, and body-mass index adjusted hazard ratios for overall VTE were 0.98 (95%CI, 0.89–1.07) for hypertension, 0.97 (0.88–1.08) for hyperlipidemia, 1.01 (0.89–1.15) for diabetes and 1.19 (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 (HR=0.79 [95% CI, 0.68–0.92] at systolic blood pressure 160 vs. 110 mmHg), 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 with 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 (0.90–1.29), respectively. Conclusions Except the association of cigarette smoking with provoked VTE, which is potentially mediated through comorbid conditions such as cancer, the modifiable traditional CVD risk factors are not associated with increased VTE risk. Higher systolic blood pressure showed inverse association with VTE.