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The Relationship Between Exercise and Risk of Venous Thrombosis in Elderly People

Authors

  • Karlijn J. Van Stralen MSc,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Carine J. M. Doggen PhD,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Thomas Lumley PhD,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Mary Cushman MD,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Aaron R. Folsom MD, MPH,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Bruce M. Psaty MD, PhD,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • David Siscovick MD, MPH,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Frits R. Rosendaal MD, PhD,

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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  • Susan R. Heckbert MD, PhD

    1. From the *Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands**Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Biostatistics, University of Washington, Seattle, Washington, Department of Epidemiology, University of Washington, Seattle, Washington, and #Department of Medicine and Health Services, University of Washington, Seattle, WashingtonDepartment of Medicine, University of Vermont, Burlington, Vermont§Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
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Address correspondence to Susan R. Heckbert, MD, PhD, Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Suite 1360, Seattle, WA 98101. E-mail: Heckbert@u.washington.edu

Abstract

OBJECTIVES: To study whether exercise is associated with the risk of venous thrombosis in elderly people.

DESIGN: Observational study with a median follow-up of 11.6 years.

SETTING: The Cardiovascular Health Study in four U.S. communities.

PARTICIPANTS: People aged 65 and older without prior venous thrombosis (deep venous thrombosis or pulmonary embolism).

MEASUREMENTS: Self-reported exercise was measured two or three times during follow-up and was defined as expending more than 500 kcal/wk on exercise, including walking for exercise. Venous thrombosis cases were verified using medical record review.

RESULTS: Of 5,534 participants, 171 developed a first venous thrombosis. Self-reported exercise at baseline was not related to the risk of venous thrombosis after adjustment for sex, age, race, self-reported health, and body mass index (adjusted hazard ratio (HRadj)=1.16, 95% confidence interval (CI)=0.84–1.61), although with exercise modeled as a time-varying exposure, overall results were in the direction of greater risk of venous thrombosis (HRadj=1.38, 95% CI=0.99–1.91). For mild-intensity exercise, such as walking, there was a nonsignificant finding in the direction of benefit (HRadj=0.75, 95% CI=0.49–1.16), but strenuous exercise, such as jogging, was associated with greater risk of venous thrombosis (HRadj=1.75, 95% CI=1.08–2.83) than no exercise at all.

CONCLUSION: In elderly people, strenuous exercise was associated with a higher risk of venous thrombosis than no exercise at all. Future studies are needed to explain this unexpected higher risk.

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