Risk factors for venous thromboembolism in pre-and postmenopausal women

• Published in: Thrombosis research 2012-10, Vol.130 (4), p.596-601
• Main Authors: Bergendal, Annica, Bremme, Katarina, Hedenmalm, Karin, Lärfars, Gerd, Odeberg, Jacob, Persson, Ingemar, Sundström, Anders, Kieler, Helle
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Case-Control Studies; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; DNA - genetics; Epidemiology; Estrogens; Female; Genetic Predisposition to Disease; Heart; Hematology, Oncology and Palliative Medicine; Hormone Replacement Therapy - adverse effects; Humans; Medical sciences; Medicin och hälsovetenskap; Menopause; Middle Aged; Odds Ratio; Overweight - complications; Postmenopause; Premenopause; Risk Factors; Venous thromboembolism; Venous Thromboembolism - epidemiology; Venous Thromboembolism - genetics; Young Adult
• ISSN: 0049-3848; 1879-2472; 1879-2472
• DOI: 10.1016/j.thromres.2012.05.024

Abstract Introduction Hemostasis in women is affected by changes of estrogen levels. The role of endogenous estrogens on risk of venous thromboembolism (VTE) remains unclear. The aim of this study was to investigate the importance of acquired and genetic risk factors for VTE in pre-and postmenopausal women. Method In a nationwide case–control study we included as cases 1470 women, 18 to 64 years of age with a first time VTE. The 1590 controls were randomly selected and matched by age to the cases. Information on risk factors was obtained by interviews and DNA-analyses. We used unconditional logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Results The ORs were generally of similar magnitude in pre- and postmenopausal women. The highest risk was for the combination of surgery and cast (adjusted OR 54.12, 95% CI 16.62-176.19) in postmenopausal women. The adjusted OR for use of menopausal hormone therapy was 3.73 (95% CI 1.86-7.50) in premenopausal and 2.22 (95% CI 1.54-3.19) in postmenopausal women. Overweight was linked to an increased risk and exercise to a decreased risk, regardless of menopausal status. Conclusion Menopausal status had only minor influence on the risk levels. Acquired transient risk factors conveyed the highest risks for VTE.