• competing risks;
  • diet;
  • multivariate models;
  • obesity;
  • risk factors

Summary.  Background: Venous thromboembolism (VTE) and cardiovascular disease (CVD) share some risk factors, including obesity, but it is unclear how dietary patterns associated with reduced risk of CVD relate to risk of VTE. Objective: To compare the relationships of adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet with the risks of CVD and VTE. Patients/Methods: We confirmed by medical record review 1094 incident cases of CVD and 675 incident VTEs during a mean follow-up of 14.6 years in 34 827 initially healthy participants in the Women’s Health Study who completed at baseline a 133-item food frequency questionnaire scored for adherence to a DASH diet. We compared estimated associations of dietary patterns with CVD and VTE from proportional hazards models in a competing risk framework. Results: Initial analyses adjusted for age, energy intake and randomized treatments showed 36–41% reduced hazards of CVD among women in the top two quintiles of DASH score relative to those in the bottom quintile (Ptrend < 0.001). In multivariate analysis, women in the top two quintiles had 12–23% reduced hazards of CVD relative to women in the bottom quintile (Ptrend = 0.04). Analyses restricted to coronary events showed more variable 10–33% reduced hazards in the top two quintiles (Ptrend = 0.09). In contrast, higher DASH scores were unrelated to risk of VTE, with a 1% reduced hazard for the top vs. bottom quintile (Ptrend = 0.95). Conclusion: An apparently strong association of adherence to the DASH diet with incidence of CVD was attenuated upon control for confounding variables. Adherence to the DASH diet was not associated with risk of VTE in women.