Physical activity and risk of venous thromboembolism: systematic review and meta-analysis of prospective cohort studies

Abstract

The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and venous thromboembolism (VTE) is divergent. We conducted a systematic review and meta-analysis of published observational prospective cohort studies evaluating the associations of physical activity with VTE risk. MEDLINE, Embase, Web of Science, and manual search of relevant bibliographies were systematically searched until 26 February 2019. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus minimal amount of physical activity groups were pooled using random effects meta-analysis. Twelve articles based on 14 unique prospective cohort studies comprising of 1,286,295 participants and 23,753 VTE events were eligible. The pooled fully-adjusted RR (95% CI) of VTE comparing the most physically active versus the least physically active groups was 0.87 (0.79-0.95). In pooled analysis of 10 studies (288,043 participants and 7069 VTE events) that reported risk estimates not adjusted for body mass index (BMI), the RR (95% CI) of VTE was 0.81 (0.70-0.93). The associations did not vary by geographical location, age, sex, BMI, and methodological quality of studies. There was no evidence of publication bias among contributing studies. Pooled observational prospective cohort studies support an association between regular physical activity and low incidence of VTE. The relationship does not appear to be mediated or confounded by BMI.stimulate further efforts to further clarify the relationship between physical activity and VTE risk.

Cardiorespiratory fitness is not associated with risk of venous thromboembolism: a cohort study

“…Given the close link between atherosclerotic CVD and VTE [6], the established relationship between CRF and atherosclerotic CVD, [12] CRF being an objective index of habitual physical activity, and the fact that both disease entities conditions share physical inactivity as a common risk factor [10], these findings may seem unexpected. Though regular physical activity leads to improved CRF, genetic as well as several other environmental factors influence CRF levels.…”

“…Till recently, evidence on the association between physical activity and the risk of VTE was divergent. In a pooled meta-analysis of 14 prospective cohort studies, we have shown that regular physical activity is associated with reduced risk of VTE [10]. Cardiorespiratory fitness (CRF), as measured by maximal oxygen uptake (VO2max), is the gold standard for assessing aerobic capacity and is an index of habitual physical activity [11].…”

Overall Impact of the COVID-19 Pandemic on Interventional Radiology Services: A Canadian Perspective

“… 9 The increased sedentary lifestyle of the population during the pandemic may be another explanation with regard to the increased incidence of venous thromboembolism during the pandemic. 10 , 11 …”

Does cardiorespiratory fitness really influence venous thromboembolism risk?

“…The independent and inverse association between CRF, an index for habitual physical activity, and the risk of arterial thrombotic disease (cardiovascular disease, CVD) is very well established. 2,3 Though emerging evidence suggests that regular physical activity is associated with reduced risk of VTE, 4 with the possibility that high CRF levels may reduce the risk of VTE, data on the nature and magnitude of the relationship between CRF and VTE was nonexistent until recently. With the publication of this recent study by Evensen et al, 1 this brings to a total of three studies that have now investigated the association between CRF and VTE risk (Table 1).…”