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The risk of incident venous thromboembolism attributed to overweight and obesity: The Tromsø Study

1Thrombosis Research Center, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway, Tromsø, Troms, Norway, 2UiT - The Arctic University of Norway, Tromsø, Troms, Norway, 3Thrombosis Research Center, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway, Tromso, Troms, Norway, 4UiT - The Arctic University of Norway, Tromsø, Norway, Tromsø, Troms, Norway

Abstract Number: OC 42.1

Meeting: ISTH 2022 Congress

Theme: Venous Thromboembolism » VTE Epidemiology

Background: Obesity is a well-established risk factor for venous thromboembolism (VTE). Further, genetically elevated body mass index (BMI) is associated with a higher risk of VTE, supporting a causal association. However, the proportion of VTE events that can be attributed to obesity in the general population has been scarcely investigated.

Aims: To estimate the population attributable fraction (PAF) of VTE due to overweight and obesity in a population-based cohort with repeated measurements of BMI.

Methods: Participants (n=36,341) attending one or more surveys of the Tromsø Study 4-7 (enrolment: 1994-2016) were followed until 2020, and all incident VTEs were recorded. Overweight and obesity were defined by a baseline BMI of 25-30 kg/m2 and ≥30 kg/m2, respectively. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using time-varying Cox regression models and adjusted for age and sex. The PAF was estimated applying a formula that takes into account the adjusted HR for overweight and obesity and their prevalence in VTE cases (pc) (PAF= pc[1 −1/HR]). Ethical approval and informed consent were obtained.

Results: During a median follow-up of 13.9 years, 1,051 incident VTEs occurred. Compared with BMI < 25 kg/m2, HRs for overweight and obesity were 1.40 (95% CI 1.21-1.61) and 1.86 (95% CI 1.58-2.20), respectively. The proportion of VTE events attributable to overweight and obesity was 24.6% (12.9% was due to overweight and 11.7% to obesity). Similar results were obtained for VTE subgroups (Table 1), and in analyses restricted to men, women, and the elderly (≥70 years).

Conclusion(s): Our findings suggest that almost 25% of all incident VTEs in the general population can be attributed to overweight and obesity. Public health interventions aimed to reduce the prevalence of overweight and obesity may substantially contribute to decrease the incidence of VTE.

Table 1

Population attributable fraction -PAF- of overall venous thromboembolism -VTE- and VTE subgroups for overweight and obesity

To cite this abstract in AMA style:

Frischmuth T, Tøndel B, Brækkan S, Hansen J, Morelli V. The risk of incident venous thromboembolism attributed to overweight and obesity: The Tromsø Study [abstract]. https://abstracts.isth.org/abstract/the-risk-of-incident-venous-thromboembolism-attributed-to-overweight-and-obesity-the-tromso-study/. Accessed September 29, 2023.

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