Tsai Albert W, Cushman Mary, Rosamond Wayne D, Heckbert Susan R, Polak Joseph F, Folsom Aaron R
Division of Epidemiology, School of Public Health, University of Minnesota, 1300 S Second St, Suite 300, Minneapolis, MN 55454, USA.
Arch Intern Med. 2002 May 27;162(10):1182-9. doi: 10.1001/archinte.162.10.1182.
The association between traditional cardiovascular risk factors and risk of venous thromboembolism (VTE) has not been extensively examined in prospective studies.
To determine whether atherosclerotic risk factors are also associated with increased incidence of VTE, we conducted a prospective study of 19 293 men and women without previous VTE in 6 US communities between 1987 and 1998.
There were 215 validated VTE events (1.45 per 1000 person-years) during a median of 8 years of follow-up. The age-adjusted hazard ratio was 1.4 (95% confidence interval [CI], 1.1-1.9) for men vs women, 1.6 (95% CI, 1.2-2.2) for blacks vs whites, and 1.7 (95% CI, 1.5-2.0) per decade of age. Cigarette smoking, hypertension, dyslipidemia, physical inactivity, and alcohol consumption were not associated with risk of VTE. Age-, race-, and sex-adjusted hazard ratios for body mass index categories (calculated as the weight in kilograms divided by the height in meters squared) of less than 25, 25 to less than 30, 30 to less than 35, 35 to less than 40, and 40 or more were 1.0, 1.5, 2.2, 1.5, and 2.7, respectively (P<.001 for the trend). Diabetes was also associated with an increased risk of VTE (adjusted hazard ratio, 1.5 [95% CI, 1.0-2.1]).
Our data showing no relationship of some arterial risk factors with VTE corroborate the view that the etiology of VTE differs from atherosclerotic cardiovascular disease. In addition, the findings suggest a hypothesis that avoidance of obesity and diabetes or vigilance in prophylaxis in patients with those conditions may prevent some venous thromboses.
传统心血管危险因素与静脉血栓栓塞症（VTE）风险之间的关联在前瞻性研究中尚未得到广泛检验。
为确定动脉粥样硬化危险因素是否也与VTE发病率增加相关，我们于1987年至1998年期间在美国6个社区对19293名既往无VTE的男性和女性进行了一项前瞻性研究。
在中位8年的随访期间，共发生215例经证实的VTE事件（每1000人年1.45例）。年龄调整后的风险比，男性与女性相比为1.4（95%置信区间[CI]，1.1 - 1.9），黑人与白人相比为1.6（95%CI，1.2 - 2.2），每增长十岁为1.7（95%CI，1.5 - 2.0）。吸烟、高血压血脂异常、缺乏身体活动和饮酒与VTE风险无关。体重指数（以千克为单位的体重除以以米为单位的身高的平方计算）类别小于25、25至小于30、30至小于35、35至小于40以及40及以上的年龄、种族和性别调整后的风险比分别为1.0、1.5、2.2、1.5和2.7（趋势P<0.001）。糖尿病也与VTE风险增加相关（调整后的风险比，1.5[95%CI，1.0 - 2.1]）。
我们的数据显示某些动脉危险因素与VTE无关联，这证实了VTE病因与动脉粥样硬化性心血管疾病不同的观点。此外，研究结果提示一个假说，即避免肥胖和糖尿病或对患有这些疾病的患者进行预防性监测可能预防一些静脉血栓形成。
