Physical activity and risk of first-time venous thromboembolism

Abstract

Background

Physical activity may have a protective effect against venous thromboembolism (VTE). The aim of this study was to investigate the association between leisure time physical activity, occupational physical activity, and the risk of VTE in men and women separately.

Methods

The population-based, prospective Venous thromboEmbolism In Northern Sweden (VEINS) cohort study included 108,025 participants of health examinations between 1985 and 2014. Physical activity data were collected by questionnaire. Participants were followed from health examination to first-time VTE event, death, emigration or the end of the study. All VTE events were validated by reviewing medical records and radiology reports.

Results

During 1,496,669 person-years, 2054 participants experienced VTE. Women who performed leisure time physical activity at least once a week had a lower risk of first-time VTE (hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.71–0.98 after adjustments) compared with women with less or no physical activity. Furthermore, women with high occupational physical activity also had a lower risk of VTE (HR 0.85; 95% CI 0.74–0.98). In men, there was no consistent association between either measure of physical activity and the risk of VTE.

Conclusion

We found an association between increased physical activity and a lower risk of first-time VTE in women.

Keywords

Venous thromboembolism venous thrombosis physical activity exercise

Get full access to this article

View all access options for this article.

References

Johansson

Lind

. Incidence of venous thromboembolism in northern Sweden (VEINS): a population-based study. Thromb J 2014; 12: 6.

Spencer

Emery

Joffe

et al.

Incidence rates, clinical profile, and outcomes of patients with venous thromboembolism. The Worcester VTE study. J Thromb Thrombolysis 2009; 28: 401–409.

Huang

Goldberg

Anderson

et al.

Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985–2009). Am J Med 2014; 127: 829–839. e825.

Wiener

Schwartz

Woloshin

. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med 2011; 171: 831–837.

Van Adrichem

Debeij

Nelissen

et al.

Below-knee cast immobilization and the risk of venous thrombosis: results from a large population-based case-control study. J Thromb Haemost 2014; 12: 1461–1469.

Hjelmstedt

. The pressure in the veins of the dorsum of the foot in quiet standing and during exercise in limbs without signs of venous disorder. Acta Chir Scand 1968; 134: 235–244.

Kugler

Strunk

Rudofsky

. Venous pressure dynamics of the healthy human leg. Role of muscle activity, joint mobility and anthropometric factors. J Vasc Res 2001; 38: 20–29.

Stick

Jaeger

Witzleb

. Measurements of volume changes and venous pressure in the human lower leg during walking and running. J Appl Physiol (1985) 1992; 72: 2063–2068.

Lippi

Maffulli

. Biological influence of physical exercise on hemostasis. Semin Thromb Hemost 2009; 35: 269–276.

10.

Smith

. Effects of strenuous exercise on haemostasis. Br J Sports Med 2003; 37: 433–435.

11.

Olson

Cushman

Judd

et al.

American Heart Association's life's simple 7 and risk of venous thromboembolism: The reasons for geographic and racial differences in stroke (REGARDS) study. J Am Heart Assoc 2015; 4: e001494.

12.

Borch

Hansen-Krone

Braekkan

et al.

Physical activity and risk of venous thromboembolism. The Tromso study. Haematologica 2010; 95: 2088–2094.

13.

Tsai

Cushman

Rosamond

et al.

Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 2002; 162: 1182–1189.

14.

Lutsey

Virnig

Durham

et al.

Correlates and consequences of venous thromboembolism: The Iowa women's health study. Am J Public Health 2010; 100: 1506–1513.

15.

Glynn

Rosner

. Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol 2005; 162: 975–982.

16.

Sidney

Petitti

Soff

et al.

Venous thromboembolic disease in users of low-estrogen combined estrogen-progestin oral contraceptives. Contraception 2004; 70: 3–10.

17.

Lindqvist

Epstein

Olsson

. The relationship between lifestyle factors and venous thromboembolism among women: a report from the MISS study. Br J Haematol 2009; 144: 234–240.

18.

Van Stralen

Le Cessie

Rosendaal

et al.

Regular sports activities decrease the risk of venous thrombosis. J Thromb Haemost 2007; 5: 2186–2192.

19.

Holst

Jensen

Prescott

. Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. Circulation 2010; 121: 1896–1903.

20.

Armstrong

Green

Reeves

et al.

Frequent physical activity may not reduce vascular disease risk as much as moderate activity: large prospective study of women in the United Kingdom. Circulation 2015; 131: 721–729.

21.

Kim

Kraft

Hagan

et al.

Interaction of a genetic risk score with physical activity, physical inactivity, and body mass index in relation to venous thromboembolism risk. Genet Epidemiol 2018; 42: 354–365.

22.

Evensen

Isaksen

Hindberg

et al.

Repeated assessments of physical activity and risk of incident venous thromboembolism. J Thromb Haemost 2018; 16: 2208–2217.

23.

Wattanakit

Lutsey

Bell

et al.

Association between cardiovascular disease risk factors and occurrence of venous thromboembolism. A time-dependent analysis. Thromb Haemost 2012; 108: 508–515.

24.

Evensen

Braekkan

Hansen

. Regular Physical Activity and Risk of Venous Thromboembolism. Semin Thromb Hemost 2018; 44: 765–779.

25.

Caspersen

Pereira

Curran

. Changes in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc 2000; 32: 1601–1609.

26.

Charreire

Casey

Salze

et al.

Leisure-time physical activity and sedentary behavior clusters and their associations with overweight in middle-aged French adults. Int J Obes (Lond) 2010; 34: 1293–1301.

27.

Hagstromer

Oja

Sjostrom

. Physical activity and inactivity in an adult population assessed by accelerometry. Med Sci Sports Exerc 2007; 39: 1502–1508.

28.

Martin

Koster

Murphy

et al.

Changes in daily activity patterns with age in US men and women: National health and nutrition examination survey 2003–04 and 2005–06. J Am Geriatr Soc 2014; 62: 1263–1271.

29.

Minges

Strait

Owen

et al.

Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study. Eur J Prev Cardiol 2017; 24: 192–203.

30.

Moschny

Platen

Klaassen-Mielke

et al.

Physical activity patterns in older men and women in Germany: A cross-sectional study. BMC Public Health 2011; 11: 559.

31.

Coenen

Huysmans

Holtermann

et al.

Do highly physically active workers die early? A systematic review with meta-analysis of data from 193,696 participants. Br J Sports Med 2018; 52: 1320–1326.

32.

Norberg M, Wall S, Boman K, et al. The Vasterbotten intervention programme: Background, design and implications. Glob Health Action 2010; 3: 4643.

33.

Johansson

Lind

Jansson

J-H

et al.

Fasting plasma glucose, oral glucose tolerance test, and the risk of first-time venous thromboembolism. A report from the VEINS cohort study. Thromb Res 2018; 165: 86–94.

34.

Consortium

. Validity of a short questionnaire to assess physical activity in 10 European countries. Eur J Epidemiol 2012; 27: 15–25.

35.

Blau

Brummund

Liu

. Trends in occupational segregation by gender 1970–2009: adjusting for the impact of changes in the occupational coding system. Demography 2013; 50: 471–492.

36.

Eng

t Mannetje

McLean

et al.

Gender differences in occupational exposure patterns. Occup Environ Med 2011; 68: 888–894.

37.

Cheng

Zhang

Cheng

et al.

Associations of leisure-time physical activity with cardiovascular mortality: A systematic review and meta-analysis of 44 prospective cohort studies. Eur J Prev Cardiol 2018; 25: 1864–1872.

38.

Norberg

Blomstedt

Lonnberg

et al.

Community participation and sustainability–evidence over 25 years in the Vasterbotten intervention programme. Glob Health Action 2012; 5: 1–9.

39.

Öhman

Johansson

Jansson

J-H

et al.

Positive predictive value and misclassification of diagnosis of pulmonary embolism and deep vein thrombosis in Swedish patient registries. Clin Epidemiol 2018; 10: 1215–1221.

40.

Dyrstad

Hansen

Holme

et al.

Comparison of self-reported versus accelerometer-measured physical activity. Med Sci Sports Exerc 2014; 46: 99–106.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.52 MB