Risk factors for venous thromboembolism in pre-and postmenopausal women.
BACKGROUND
Hemostasis in women is affected by changes of estrogen levels. The role of endogenous estrogens on risk of venous thromboembolism (VTE) remains unclear. The aim of this study was to investigate the importance of acquired and genetic risk factors for VTE in pre-and postmenopausal women.


METHODS
In a nationwide case-control study we included as cases 1470 women, 18 to 64years of age with a first time VTE. The 1590 controls were randomly selected and matched by age to the cases. Information on risk factors was obtained by interviews and DNA-analyses. We used unconditional logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs).


RESULTS
The ORs were generally of similar magnitude in pre- and postmenopausal women. The highest risk was for the combination of surgery and cast (adjusted OR 54.12, 95% CI 16.62-176.19) in postmenopausal women. The adjusted OR for use of menopausal hormone therapy was 3.73 (95% CI 1.86-7.50) in premenopausal and 2.22 (95% CI 1.54-3.19) in postmenopausal women. Overweight was linked to an increased risk and exercise to a decreased risk, regardless of menopausal status.


CONCLUSIONS
Menopausal status had only minor influence on the risk levels. Acquired transient risk factors conveyed the highest risks for VTE.
Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden. annica.bergendal@ki.se
Annica
A
Bergendal
Katarina
K
Bremme
Karin
K
Hedenmalm
Gerd
G
Lärfars
Jacob
J
Odeberg
Ingemar
I
Persson
Anders
A
Sundström
Helle
H
Kieler
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004247:DNA / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D050177:Overweight / Q000150:complications; D017698:Postmenopause; D017697:Premenopause; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000235:genetics*; D055815:Young Adult
D004247:DNA