Smoking and venous thromboembolism: a Danish follow-up study

Abstract

Summary. Background: Large-scale prospective studies are needed to assess whether smoking is associated with venous thromboembolism (VTE) (i.e. deep venous thrombosis and pulmonary embolism) independently of established risk factors. Objective: To investigate the association between smoking and the risk of VTE among middle-aged men and women. Methods: From 1993 to 1997, 27 178 men and 29 875 women, aged 50-64 years and born in Denmark, were recruited into the Danish prospective study ÔDiet, Cancer and HealthÕ. During follow-up, VTE cases were identified in the Danish National Patient Registry. Medical records were reviewed and only verified VTE cases were included in the study. Baseline data on smoking and potential confounders were included in gender stratified Cox proportional hazard models to asses the association between smoking and the risk of VTE. The analyses were adjusted for alcohol intake, body mass index, physical activity, and in women also for use of hormone replacement therapy. Results: During follow-up, 641 incident cases of VTE were verified. We found a positive association between current smoking and VTE, with a hazard ratio of 1.52 (95% CI, 1.15-2.00) for smoking women and 1.32 (95% CI, 1.00-1.74) for smoking men, and a positive dose-response relationship. Former smokers had the same hazard as never smokers. Conclusions: Smoking was an independent risk factor for VTE among middle-aged men and women. Former smokers have the same risk of VTE as never smokers, indicating acute effects of smoking, and underscoring the potential benefits of smoking cessation.

Effects of physical activity, body mass index, waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

“…Another prospective study of mortality showed that BMI had U-shaped and negative linear functions in younger and older women, respectively, but WHR had positive linear trends both in younger and older women [51]. Recently, a Danish study of anthropometric measures found that hip circumference was positively associated with venous thromboembolism in women [52]. We could not see an association between hip circumference and mortality in our study.…”

The increased risk of venous thromboembolism by advancing age cannot be attributed to the higher incidence of cancer in the elderly: the Tromsø study

“…Agespecific incidence rates and relative risks were reported in a previous Danish registry study [16]that had linked a cohort of 57 600 cancer patients witha cohort of 287 000 controls selected from the general population.Since the primary outcome of the Danish study was hospitalization for VTE, the incidence rates and risk estimates were not directly comparable to our study which included both hospitalized and outpatient treated VTEs. Moreover, when a subgroup of the VTE diagnoses in the registry were validated, the codes for hospitalized VTE cases had a low positive predictive value (PPV 75 %), particularly when VTE was a secondary discharge diagnosis (PPV 67 %) [23]. However, similar to our findings, the Danish study reported increasing incidence rates of VTE across older age groups among cancer patients, while the relative risks of VTE by cancer was highest among the young.…”

Short‐Term E‐Cigarette Exposure Increases the Risk of Thrombogenesis and Enhances Platelet Function in Mice

“…Although cigarette smoking has been shown to produce effects in vivo, for example, to increase the risk of various disease states, including those involving thrombogenesis,49, 50 whether e‐cigarette exposure produces similar effects or not remains to be determined. Thus, we first evaluated the effect of e‐cigarette exposure on the hemostasis response by conducting the tail bleeding time assay in live, anesthetized mice.…”