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Epidemiology and Population Health

Weight change over 9 years and subsequent risk of venous thromboembolism in the ARIC cohort

Abstract

Background/objectives

Weight gain increases risk of cardiovascular disease, but has not been examined extensively in relationship to venous thromboembolism (VTE). The association between weight change over 9 years and subsequent VTE among participants in the Atherosclerosis Risk in Communities (ARIC) study was examined, with a hypothesis that excess weight gain is a risk factor for VTE, relative to no weight change.

Subjects/methods

Quintiles of 9-year weight change were calculated (visit 4 1996–1998 weight minus visit 1 1987–1989 weight in kg: Quintile 1: ≥−1.81 kg; Quintile 2: <−1.81 to ≤1.36 kg; Quintile 3: >1.36 to ≤4.08 kg; Quintile 4: >4.08 to ≤7.71 kg; Quintile 5: >7.71 kg). Incident VTEs from visit 4 (1996–1998) through 2015 were identified and adjudicated using medical records. Hazard ratios (HRs) were calculated using Cox models.

Results

529 incident VTEs were identified during an average of 19 years of follow up. Compared to Quintile 2, participants in Quintile 5 of weight change had 1.46 times the rate of incident VTE (HR = 1.46 (95% CI 1.09, 1.95), adjusted for age, race, sex, income, physical activity, smoking, and prevalent CVD). The HR for Quintile 5 was modestly attenuated to 1.38 (95% CI 1.03, 1.84) when visit 1 BMI was included in the model. When examined separately, results were significant for unprovoked VTE, but not for provoked VTE. Among those obese at visit 1, both weight gain (HR 1.86 95% CI 1.27, 2.71) and weight loss (HR 2.11 95% CI 1.39, 3.19) were associated with incident VTE, compared with normal-weight participants with no weight change.

Conclusions

Weight gain later life was associated with increased risk for unprovoked VTE. Among those with obesity, both weight gain and weight loss were associated with increased risk for VTE.

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Acknowledgements

The National Heart, Lung, and Blood Institute provided support for the ARIC study via contracts HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I and for this venous thromboembolism research via R01HL059367. We thank the ARIC participants and staff for their important contributions to ARIC research.

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Correspondence to Simone A. French.

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French, S.A., Lutsey, P.L., Rosamond, W. et al. Weight change over 9 years and subsequent risk of venous thromboembolism in the ARIC cohort. Int J Obes 44, 2465–2471 (2020). https://doi.org/10.1038/s41366-020-00674-5

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