Regular Physical Activity and Risk of Venous Thromboembolism

Abstract

Venous thromboembolism (VTE) is a complex multifactorial disease that represents a growing public health concern. Identification of modifiable risk factors at the population level may provide a measure to reduce the burden of VTE. In this review, we summarize current knowledge of the role of physical activity on the risk of VTE and VTE-related complications.We also discuss methodological challenges related to research on physical activity, and put forward plausible mechanisms for an association between physical activity and VTE. Up to now, published studies have reported diverging results on the relationship between physical activity and VTE, and a complex picture has emerged. However, the available evidence appears to be balanced towards a small beneficial effect of physical activity on the risk of incident VTE, but not in a dose-dependent manner. Still, the lack of an operational definition and standardized assessment method for physical activity as well as several sources of bias, impair the interpretation of the available literature. Additional work is necessary to understand the role and how to apply physical activity in the VTE-setting. Future research should utilize objective assessment strategies of physical activity and physical fitness, account for the fluctuating nature in habitual activity levels, and explore the role of physical activity in the areas of secondary prevention and VTE-related complications.

Physical activity and risk of venous thromboembolism: systematic review and meta-analysis of prospective cohort studies

“…Though there has been overwhelming evidence showing that regular physical activity is associated with reduced risk of arterial thrombotic disease [1][2][3], findings on the relationship between physical activity and VTE risk have been mixed in the absence of a pooled analysis. In a recently published narrative review that evaluated the existing epidemiological evidence on the association between physical activity and VTE risk, Evensen and Table 1 colleagues concluded that there might be a modest beneficial effect of physical activity on incident VTE risk [34]. However, the evidence was hampered by the variance in the assessment and definition of the exposure variablephysical activity.…”

“…Some studies have reported decreased VTE risk with increased physical activity [26][27][28], whereas others have shown increased VTE risk with increased physical activity [29,30] or no significant evidence of associations [31][32][33]. In a recent narrative review of existing observational prospective evidence, the authors evaluated and concluded that there may be a small beneficial effect of physical activity on the risk of incident VTE, but this did not appear to be consistent with a dose-response relationship [34]. A number of randomised controlled trials and observational studies have assessed the benefits and risks of physical activity on VTE, but these were based in patients or populations with acute or previous DVT [35].…”