Body Height and Risk of Venous Thromboembolism: The Tromsø Study

American Journal of Epidemiology, May 2010

An association between body height and venous thromboembolism (VTE) has been suggested by previous studies including males only. The aim of this prospective cohort study was to investigate the sex-specific impact of body height on risk of VTE in a general population. Risk factors, including body height and weight, were registered for 26,727 subjects aged 25–96 years who participated in the Tromsø Study (Norway) in 1994–1995. Incident VTE events were registered through September 1, 2007. There were 462 VTE events during a median 12.5 years of follow-up. Body height was a risk factor for VTE in men, but not in women. Multivariable hazard ratios per 10 cm, adjusted for age, body mass index, diabetes, smoking, and hormone therapy (women), were 1.34 (95% confidence interval: 1.09, 1.64) for men and 1.13 (95% confidence interval: 0.91, 1.40) for women. Hazard ratios by quartiles of body height revealed that men in the upper quartile (>181 cm) had a 1.99-fold (95% confidence interval: 1.35, 2.92) increased risk of VTE compared with men in the lowest quartile (<173 cm) (P for trend across quartiles = 0.002). There was no significant trend (P = 0.2) across quartiles of body height for women. Study findings revealed that body height is a sex-specific risk factor for VTE in men.

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Body Height and Risk of Venous Thromboembolism: The Tromsø Study

The Troms Study 0 Sigrid K. Braekkan ) 0 Knut H. Borch 0 Ellisiv B. Mathiesen 0 Inger Njlstad 0 Tom Wilsgaard 0 John-Bjarne Hansen 0 0 Institute of Clinical Medicine, University of Troms , N-9037 Troms, Norway ( American Journal of Epidemiology The Author 2010. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: . An association between body height and venous thromboembolism (VTE) has been suggested by previous studies including males only. The aim of this prospective cohort study was to investigate the sex-specific impact of body height on risk of VTE in a general population. Risk factors, including body height and weight, were registered for 26,727 subjects aged 25-96 years who participated in the Troms Study (Norway) in 1994-1995. Incident VTE events were registered through September 1, 2007. There were 462 VTE events during a median 12.5 years of follow-up. Body height was a risk factor for VTE in men, but not in women. Multivariable hazard ratios per 10 cm, adjusted for age, body mass index, diabetes, smoking, and hormone therapy (women), were 1.34 (95% confidence interval: 1.09, 1.64) for men and 1.13 (95% confidence interval: 0.91, 1.40) for women. Hazard ratios by quartiles of body height revealed that men in the upper quartile (>181 cm) had a 1.99-fold (95% confidence interval: 1.35, 2.92) increased risk of VTE compared with men in the lowest quartile (<173 cm) (P for trend across quartiles 0.002). There was no significant trend (P 0.2) across quartiles of body height for women. Study findings revealed that body height is a sex-specific risk factor for VTE in men. body height; risk factors; venous thromboembolism Abbreviations: CI, confidence interval; HR, hazard ratio; VTE, venous thromboembolism. - Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common multifactor disease, with serious short-term and long-term complications and a potentially fatal outcome (1). The annual incidence is approximately 13 per 1,000 adults in developed countries (1, 2), and VTE is the third most common cardiovascular disease (3, 4). Even though surgery, trauma, hospitalization, malignancy, immobilization, pregnancy, use of estrogens, and inherited thrombophilia are associated with VTE events (1, 5), 30%50% of the events still are not associated with obvious predisposing factors (6, 7). Several investigations have consistently shown that anthropometric measures of obesity, such as body mass index and waist circumference, are strong and independent risk factors for VTE in population-based studies (810), in outpatients (11), and in patients discharged from hospitals (12). In contrast, the impact of other anthropometric measures, such as body height, on risk of VTE has received little attention. In the mid-19th century, Virchow acknowledged blood stasis as a major contributor to venous thrombosis (13), and body height was later shown to affect venous pressure dynamics (14, 15). Thus, it is likely that body height may affect risk of VTE. Data from the Physicians Health Study (3), including only male physicians, showed that taller men had an increased risk of VTE. Similar findings were reported in a cohort of Swedish men (16). To the best of our knowledge, no study has addressed the sex-specific impact of body height on risk of VTE. Thus, we wanted to investigate whether body height was an independent risk factor for VTE in men and women. To address this question, we performed a prospective, population-based study of 26,727 adults, of whom 47.5% were males, and assessed the impact of body height on the incidence of VTE in sex-stratified analysis. MATERIALS AND METHODS Study population Participants were recruited from the fourth survey of the Troms Study (conducted in 19941995), a singlecenter, prospective, population-based study with repeated health surveys of inhabitants of Troms, Norway. All inhabitants older than age 24 years were invited, and 27,158 participated (77% of the eligible population). Data were collected by physical examination, blood samples, and self-administered questionnaires. The study was approved by the regional committee for research ethics, and all participants gave their informed, written consent. Subjects who did not consent to medical research (n 300) and those not officially registered as inhabitants of the municipality of Troms (n 43) were excluded from the study. Furthermore, subjects with a known history of VTE (n 47) and those with missing values for body height (n 41) were excluded. Therefore, 26,727 subjects were included in our study. Incident VTE events among the study participants were recorded from the date of enrollment through the end of follow-up, September 1, 2007. Baseline measurements Body height and weight were measured with subjects wearing light clothing and no shoes. Height was measured to the nearest centimeter and wei (...truncated)


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Sigrid K. Brækkan, Knut H. Borch, Ellisiv B. Mathiesen, Inger Njølstad, Tom Wilsgaard, John-Bjarne Hansen. Body Height and Risk of Venous Thromboembolism: The Tromsø Study, American Journal of Epidemiology, 2010, pp. 1109-1115, 171/10, DOI: 10.1093/aje/kwq066