Objectives-To document the incidence, case-fatality, and recurrence of venous thromboembolism (VTE) in women, and to explore the relation of demographic, lifestyle, and anthropometric factors to VTE incidence.
Methods-In 1986Iowa women aged 55-69 completed a mailed survey. These data were linked to Medicare data for 1986-2004 (n=40,377) to identify hospitalized VTE cases. Cox regression adjusted for age, education, smoking status, physical activity, and BMI.Results-2,137 women developed VTE, yielding an incidence rate of 4.04/1,000 person-years. The 28-day case-fatality was 7.7% and the 1-year recurrence, 3.4%. Educational attainment and age-at-menopause were inversely associated with VTE, as was physical activity, prior to BMI adjustment. The risk of secondary (particularly cancer-related) VTE was increased in smokers compared with never smokers. BMI, waist circumference, waist-hip-ratio height, and diabetes were positively associated with VTE risk. Hormone replacement therapy use was associated with increased risk of idiopathic VTE, while parity was unrelated.
Human Subjects StatementThe University of Minnesota Institutional Review Board approved this study, and all participants gave informed consent.Author Contributions PL Lutsey, AR Folsom, and BA Virnig designed the study and led in writing the manuscript. PL Lutsey conducted the analysis, with assistance from SB Durham and DR Jacobs, Jr. All authors helped to conceptualize ideas, interpret findings, and review drafts of the manuscript.
NIH Public Access
Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2011 August 1.
NIH-PA Author ManuscriptConclusions-VTE is a significant source of morbidity and mortality in older women. Risk was elevated among women who were smokers, physically inactive, overweight, and diabetic, indicating that lifestyle contributes to VTE risk.