In the Journals

Greater cardiorespiratory fitness may reduce risk for venous thromboembolism

Higher estimated cardiorespiratory fitness levels appeared associated with a lower risk for venous thromboembolism, according to results of a population-based cohort study published in Journal of Thrombosis and Haemostasis.

Researchers observed the correlation independent of weight status, which suggests a higher estimated cardiorespiratory fitness level may attenuate the association between obesity and VTE.

“With an aging population and a rising prevalence of obesity and cancer, the incidence of VTE is expected to increase in the coming years,” Line H. Evensen, MSc, PhD fellow in the department of clinical medicine at The Arctic University of Norway, and colleagues wrote. “Identification of modifiable risk factors at the population level is currently a priority to curb the growing burden of VTE.”

Growing evidence has linked physical activity to a lower risk for VTE; however, that evidence is controversial because of inconsistent definitions of physical activity, the variety of measuring instruments available and a reliance on self-reported data.

Evensen and colleagues analyzed 10,393 inhabitants (mean age, 56 years; 53.1% women) of Tromsø, Norway, who participated in the sixth survey of the Tromsø Study in 2007 and 2008. The researchers sought to identify associations between cardiorespiratory fitness and VTE risk among the population sample and to determine whether body weight influenced such associations.

Cardiorespiratory fitness was estimated based on sex-specific algorithms that accounted for age, waist circumference, resting heart rate and self-reported physical activity.

Mean estimated cardiorespiratory fitness was 31.5 ± 5.7 mL/kg/min among women and 38.8 ± 6.8 mL/kg/min among men.

Results showed that after 83,729 person-years of follow-up (median duration, 8.5 years; interquartile range, 8.2-8.9), 176 VTE events occurred, for a crude incidence rate of 2.1 (95% CI, 1.8-2.4) per 1,000 person years.

Median age at the time of incident VTE was 69 years, and 55.1% of all events occurred among men.

Pulmonary embolism with or without concomitant deep vein thrombosis accounted for 56.3% of all events, with the remainder (43.7%) being isolated incidences of DVT.

Additionally, cancer played a provoking role in 30.7% of the VTE events.

Compared with individuals who had estimated cardiorespiratory fitness less than 85% of age-predicted level, those with cardiorespiratory fitness of 85% to 100% of age-predicted level had a 46% (HR = 0.54; 95% CI, 0.39-0.77) lower risk for VTE, whereas those with more than 100% of age-predicted cardiorespiratory fitness had a 67% (HR = 0.33; 95% CI, 0.2-0.54) lower risk.

Compared with individuals who were overweight or obese with less than 85% of age-predicted estimated cardiorespiratory fitness, overweight or obese individuals with 85% or greater age-predicted cardiorespiratory fitness had a 50% (HR = 0.5; 95% CI, 0.35-0.74) lower risk for VTE. Moreover, individuals with a normal weight and estimated cardiorespiratory fitness of at least 85% of age-predicted level had a 55% (HR = 0.45; 95% CI, 0.3-0.68) lower VTE risk.

A high number of exclusions, as well as a reliance on self-reported data, served as the study’s primary limitations.

“We found that higher estimated cardiorespiratory fitness , obtained from easily available variables, was associated with a lower risk [for] incident VTE,” Evensen and colleagues wrote. “The association was independent of weight status, suggesting that estimated cardiorespiratory fitness may counterbalance the elevated VTE risk associated with a high body weight.” – by John DeRosier

Disclosures: The authors report no relevant financial disclosures.

Higher estimated cardiorespiratory fitness levels appeared associated with a lower risk for venous thromboembolism, according to results of a population-based cohort study published in Journal of Thrombosis and Haemostasis.

Researchers observed the correlation independent of weight status, which suggests a higher estimated cardiorespiratory fitness level may attenuate the association between obesity and VTE.

“With an aging population and a rising prevalence of obesity and cancer, the incidence of VTE is expected to increase in the coming years,” Line H. Evensen, MSc, PhD fellow in the department of clinical medicine at The Arctic University of Norway, and colleagues wrote. “Identification of modifiable risk factors at the population level is currently a priority to curb the growing burden of VTE.”

Growing evidence has linked physical activity to a lower risk for VTE; however, that evidence is controversial because of inconsistent definitions of physical activity, the variety of measuring instruments available and a reliance on self-reported data.

Evensen and colleagues analyzed 10,393 inhabitants (mean age, 56 years; 53.1% women) of Tromsø, Norway, who participated in the sixth survey of the Tromsø Study in 2007 and 2008. The researchers sought to identify associations between cardiorespiratory fitness and VTE risk among the population sample and to determine whether body weight influenced such associations.

Cardiorespiratory fitness was estimated based on sex-specific algorithms that accounted for age, waist circumference, resting heart rate and self-reported physical activity.

Mean estimated cardiorespiratory fitness was 31.5 ± 5.7 mL/kg/min among women and 38.8 ± 6.8 mL/kg/min among men.

Results showed that after 83,729 person-years of follow-up (median duration, 8.5 years; interquartile range, 8.2-8.9), 176 VTE events occurred, for a crude incidence rate of 2.1 (95% CI, 1.8-2.4) per 1,000 person years.

Median age at the time of incident VTE was 69 years, and 55.1% of all events occurred among men.

Pulmonary embolism with or without concomitant deep vein thrombosis accounted for 56.3% of all events, with the remainder (43.7%) being isolated incidences of DVT.

Additionally, cancer played a provoking role in 30.7% of the VTE events.

Compared with individuals who had estimated cardiorespiratory fitness less than 85% of age-predicted level, those with cardiorespiratory fitness of 85% to 100% of age-predicted level had a 46% (HR = 0.54; 95% CI, 0.39-0.77) lower risk for VTE, whereas those with more than 100% of age-predicted cardiorespiratory fitness had a 67% (HR = 0.33; 95% CI, 0.2-0.54) lower risk.

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Compared with individuals who were overweight or obese with less than 85% of age-predicted estimated cardiorespiratory fitness, overweight or obese individuals with 85% or greater age-predicted cardiorespiratory fitness had a 50% (HR = 0.5; 95% CI, 0.35-0.74) lower risk for VTE. Moreover, individuals with a normal weight and estimated cardiorespiratory fitness of at least 85% of age-predicted level had a 55% (HR = 0.45; 95% CI, 0.3-0.68) lower VTE risk.

A high number of exclusions, as well as a reliance on self-reported data, served as the study’s primary limitations.

“We found that higher estimated cardiorespiratory fitness , obtained from easily available variables, was associated with a lower risk [for] incident VTE,” Evensen and colleagues wrote. “The association was independent of weight status, suggesting that estimated cardiorespiratory fitness may counterbalance the elevated VTE risk associated with a high body weight.” – by John DeRosier

Disclosures: The authors report no relevant financial disclosures.