Obesity measures and risk of venous thromboembolism and myocardial infarction

Abstract

Obesity is a risk factor for arterial and venous thromboembolism. However, it is not known whether obesity mediates risk through shared mechanisms. In a population-based cohort, we aimed to compare the impact of obesity measures on risk of venous thromboembolism (VTE) and myocardial infarction (MI), and explore how obesity-related atherosclerotic risk factors influenced these relationships. Measures of body composition including body mass index , waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR) and waist-to-height ratio (WHtR) were registered in 6,708 subjects aged 25-84 years, who participated in the Tromsø Study (1994-1995). Incident VTE- and MI-events were registered until January 1, 2011. There were 288 VTEs and 925 MIs during a median of 15.7 years of follow-up. All obesity measures were related to risk of VTE. In linear models, WC showed the highest risk estimates in both genders. In categorized models (highest versus lowest quintile), WC showed highest risk in men (HR 3.59; 95 % CI 1.82-7.06) and HC in women (HR 2.27; 95 % CI 1.54-4.92). Contrary, WHR and WHtR yielded the highest risk estimates for MI. The HR of MI (highest vs. lowest quintile) for WHR was 2.11 (95 % CI 1.59-2.81) in men and 1.62 (95 % CI 1.13-2.31) in women. The risk estimates for MI were substantially attenuated after adjustment for atherosclerotic risk factors, whereas the estimates for VTE remained unchanged. Our findings suggest that the impact of body fat distribution, and the causal pathway, differs for the association between obesity and arterial and venous thrombosis.

Body size measures, hemostatic and inflammatory markers and risk of venous thrombosis: The Longitudinal Investigation of Thromboembolism Etiology

“…We previously reported an association of higher waist circumference with VT in a study focused on metabolic syndrome and VT risk[24]. In the Tromso study, among different measures of body size, the top quintile of waist circumference showed the highest risk estimates for VT; HR 3.6 in men and 2.3 in women [25]. The highest RR in the current study was for BMI in the top quartile, RR 3.0.…”

Preventing and Experiencing Ischemic Heart Disease as a Woman: State of the Science

“…45,74–76 Horvei and colleagues reported that waist-to-hip ratios and waist-to-height ratios had the greatest risk for AMI in women who participated in the Tromso Study (1994–1995) and were evaluated up to 2011. 77 In another study in patients with IHD and hypertension, the majority of obese individuals were women (67.1%) and they had a higher prevalence of diabetes, dyslipidemia, and left ventricular hypertrophy and heart failure than normal weight women. 78 In addition, hypertension was only controlled in less than 35% of obese individuals, compared to 52% in normal weight individuals, and diabetes was controlled in only 18% of obese individuals compared to 43% in normal weight individuals.…”

Hormonal Contraception Use is Common Among Patients with Inflammatory Bowel Diseases and an Elevated Risk of Deep Vein Thrombosis

“…11 Obesity is a dose-dependent risk factor for VTE with an estimated hazard ratio of 1.07 per standard deviation or 2.14 for obese versus normal weight women. 12, 13 Current smoking confers a relatively small increase in risk for VTE, with a relative risk of 1.23 in a recent meta-analysis. 26 Age is also a strong risk factor for VTE.…”