Regular Exercise Reduces Risk Of Blood Clots
21 Nov 2007
According to a new study published in Journal of Thrombosis and Haemostasis, regular participation in sports reduces the risk of developing blood clots by 39 percent in women and 22 percent in men.
Researchers from Leiden University Medical Center in the Netherlands evaluated 7,860 people aged 18-70. Patients who had suffered their first blood clot in a leg vein or lung artery were compared with control subjects who had never experienced blood clots. 31 percent of the patients and 40 percent of the control group participated in sports on a regular basis.
Overall figures for both sexes showed that participating in sports at least once per week, regardless of the type of sport or its intensity, reduced the risk of developing a blood clot in a lung artery by 46 percent and a blood clot in a leg vein by 24 percent. "Women were shown to be even more likely to reap the benefits of regular sporting activities than men," says F.R. Rosendaal, co-author of the study. "When we excluded women who were pregnant or receiving oral contraceptive or hormone replacement therapy - all possible causes of blood clots - the risk for women was reduced by 55 percent."
The authors note that, while strenuous activity is known to increase the risk of blood clot development in the elderly, regular exercise is also shown to greatly benefit the heart, and that the net effect of elderly sports participation may be positive.
The findings also show that people who did not participate in sports were more than four-times as likely to develop a blood clot if they were obese (with a body mass index of 30 or greater) than lean (with a body mass index of less than 25). "When we looked at the results, we found that, overall, the mere fact that people took part in a sporting activity at least once a week was enough to lower their risk of blood clots," say the authors.
Article adapted by Medical News Today from original press release.
Showing posts with label Deep Vein Thrombosis. Show all posts
Showing posts with label Deep Vein Thrombosis. Show all posts
Wednesday, November 21, 2007
Wednesday, September 19, 2007
ESC Congress - News - 2007 - anti-coagulation therapy in venous thrombo-embolism
Intensity and duration of oral anti-coagulation therapy in venous thrombo-embolism
J. F. Lassen and Prof. S.D. Kristensen
Aarhus, Denmark
Member and Vice-chairman and of the working group on Thrombosis
After initial medium-intensity warfarin therapy for 6 months (INR 2.0-3.0), long-term, low-intensity warfarin therapy (INR 1.5-2.0) is superior to placebo in patients with idiopathic venous thrombo-embolism.
Anti-coagulation (AC) therapy with heparins followed by oral vitamin K-antagonists is recommended after deep venous thrombosis (DVT) and pulmonary embolism. The bleeding risk is related to the duration and intensity of AC therapy. A target INR of 2.0-3.0 is as effective as high-intensity AC therapy with target INR of 3.0-4.5 and causes less bleeding (1). This intensity of AC therapy is usually recommended after DVT or pulmonary embolism.
Recommended duration of therapy is: 1) in patients with reversible or time-limited risk factors: 3 months of AC therapy, 2) first episode of idiopathic venous thrombo-embolism: at least 6 months 3) recurrent idiopathic venous thrombo-embolism or long-term risk factors: 12 months or life-long (2). In case persistent DVT and verified on a duplex scan after e.g. 6 months of therapy, one might consider prolonged AC therapy. Initiation of AC therapy with a loading dose is often used. However, this approach does not necessarily bring the therapy more quickly into the therapeutic range.
Recently, Ridker and co-workers assessed the effects of low intensity warfarin (target INR 1.5-2.0) in patients with idiopathic venous thrombo-embolism (3). The 508 patients were all treated with full-dose AC therapy for at least 6 months (median 6.5 month) and then randomised to low-intensity warfarin or placebo and followed for up to 4.3 years (median 2.1 years). In the placebo group, 37 developed recurrent venous thrombo-embolism (7.2 per 100 person-years) as compared with 14 in the low-intensity warfarin group (2.6 per 100 person-year) – a risk reduction of 64% (p<0.001). Major bleeding occurred in two patients in the placebo vs. five patients in the low intensity warfarin group (p=0.25). Low intensity warfarin was associated with a 48% reduction in the composite end point recurrent venous thrombo-embolism, major haemorrhage or death.
Preliminary data from Kearon et al shows that initial low-intensity warfarin (target INR 1.5-1.9) is significantly less effective than conventional-intensity warfarin (target INR 2.0-3.0) (4).
Therefore, it seems appropriate to wait for the publication of more trials. While waiting for such trials initial therapy with target INR 2.0-3.0 for at least 6 months followed by low intensity AC therapy might be an option in some patients. Also, new drugs like oral thrombin inhibitors should be tested in this setting.
1) Hull R, Hirsh J, Gent M et al. Different intensities of oral anti-coagulant therapy in the treatment of deep proximal-vein thrombosis. N Engl J Med 1982; 307: 1676-81.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6755255&dopt=Abstract
2) Hirsh J, Dalen JE, Anderson DR et al. Oral anticoagulants: mechanism of action, clinical effectiveness and optimal therapeutic range. Chest 2001; 119: Suppl:8S-21S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11157640&dopt=Abstract
3) Ridker PM, Goldhaber SZ, Danielson E et al. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thrombo-embolism. N Engl J Med 2003; 348: 1425-34.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12601075&dopt=Abstract
4) Kearon C, Ginsberg JS, Kovacs M et al. Low-intensity (INR 1.5-1.9) versus conventional-intensity (INR 2.0-3.0) anticoagulation for extended treatment of unprovoked VTE: a randomized double blind trial. Blood 2002; 100: 150a (abstract).http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12565715&dopt=Abstract
J. F. Lassen and Prof. S.D. Kristensen
Aarhus, Denmark
Member and Vice-chairman and of the working group on Thrombosis
After initial medium-intensity warfarin therapy for 6 months (INR 2.0-3.0), long-term, low-intensity warfarin therapy (INR 1.5-2.0) is superior to placebo in patients with idiopathic venous thrombo-embolism.
Anti-coagulation (AC) therapy with heparins followed by oral vitamin K-antagonists is recommended after deep venous thrombosis (DVT) and pulmonary embolism. The bleeding risk is related to the duration and intensity of AC therapy. A target INR of 2.0-3.0 is as effective as high-intensity AC therapy with target INR of 3.0-4.5 and causes less bleeding (1). This intensity of AC therapy is usually recommended after DVT or pulmonary embolism.
Recommended duration of therapy is: 1) in patients with reversible or time-limited risk factors: 3 months of AC therapy, 2) first episode of idiopathic venous thrombo-embolism: at least 6 months 3) recurrent idiopathic venous thrombo-embolism or long-term risk factors: 12 months or life-long (2). In case persistent DVT and verified on a duplex scan after e.g. 6 months of therapy, one might consider prolonged AC therapy. Initiation of AC therapy with a loading dose is often used. However, this approach does not necessarily bring the therapy more quickly into the therapeutic range.
Recently, Ridker and co-workers assessed the effects of low intensity warfarin (target INR 1.5-2.0) in patients with idiopathic venous thrombo-embolism (3). The 508 patients were all treated with full-dose AC therapy for at least 6 months (median 6.5 month) and then randomised to low-intensity warfarin or placebo and followed for up to 4.3 years (median 2.1 years). In the placebo group, 37 developed recurrent venous thrombo-embolism (7.2 per 100 person-years) as compared with 14 in the low-intensity warfarin group (2.6 per 100 person-year) – a risk reduction of 64% (p<0.001). Major bleeding occurred in two patients in the placebo vs. five patients in the low intensity warfarin group (p=0.25). Low intensity warfarin was associated with a 48% reduction in the composite end point recurrent venous thrombo-embolism, major haemorrhage or death.
Preliminary data from Kearon et al shows that initial low-intensity warfarin (target INR 1.5-1.9) is significantly less effective than conventional-intensity warfarin (target INR 2.0-3.0) (4).
Therefore, it seems appropriate to wait for the publication of more trials. While waiting for such trials initial therapy with target INR 2.0-3.0 for at least 6 months followed by low intensity AC therapy might be an option in some patients. Also, new drugs like oral thrombin inhibitors should be tested in this setting.
1) Hull R, Hirsh J, Gent M et al. Different intensities of oral anti-coagulant therapy in the treatment of deep proximal-vein thrombosis. N Engl J Med 1982; 307: 1676-81.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6755255&dopt=Abstract
2) Hirsh J, Dalen JE, Anderson DR et al. Oral anticoagulants: mechanism of action, clinical effectiveness and optimal therapeutic range. Chest 2001; 119: Suppl:8S-21S.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11157640&dopt=Abstract
3) Ridker PM, Goldhaber SZ, Danielson E et al. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thrombo-embolism. N Engl J Med 2003; 348: 1425-34.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12601075&dopt=Abstract
4) Kearon C, Ginsberg JS, Kovacs M et al. Low-intensity (INR 1.5-1.9) versus conventional-intensity (INR 2.0-3.0) anticoagulation for extended treatment of unprovoked VTE: a randomized double blind trial. Blood 2002; 100: 150a (abstract).http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12565715&dopt=Abstract
Sunday, August 26, 2007
Hormone therapy and thromboembolic disease.
Hormone therapy and thromboembolic disease.
Hemostasis and thrombosis Current Opinion in Hematology. 14(5):488-493, September 2007.
Battaglioli, Tullia; Martinelli, Ida
Abstract:
Purpose of review:
Hormone therapy increases the risk of venous thromboembolism (VTE). To reduce this risk, changes in dosage, composition and route of administration have been made over the years. This review provides a summary of the available evidence and an update on the most recent findings on the issue.
Recent findings:
Contraceptives containing third-generation progestagens confer a higher risk of VTE than second-generation compounds. Little data are available on preparations containing less than 30 [mu]g of estrogen, new progestagens or levonorgestrel-releasing intrauterine devices. Hormone replacement therapy increases the risk of VTE by 2 to 3-fold. Transdermal administration may be less thrombogenic than oral administration, while different estrogens and progestagens may carry a different risk. VTE risk is further increased in carriers of inherited thrombophilia. Despite a similar increase in relative risk of thrombosis associated with hormone therapy, absolute risk is lower in fertile women and higher in postmenopausal ones. Universal screening for thrombophilia before prescribing hormone replacement therapy might be cost-effective.
Summary:
Careful evaluation of individual risk factor is warranted before prescribing hormone therapy. Further investigations are needed to establish whether or not newer compounds are safer than older ones with respect to the risk of thrombosis.
Hemostasis and thrombosis Current Opinion in Hematology. 14(5):488-493, September 2007.
Battaglioli, Tullia; Martinelli, Ida
Abstract:
Purpose of review:
Hormone therapy increases the risk of venous thromboembolism (VTE). To reduce this risk, changes in dosage, composition and route of administration have been made over the years. This review provides a summary of the available evidence and an update on the most recent findings on the issue.
Recent findings:
Contraceptives containing third-generation progestagens confer a higher risk of VTE than second-generation compounds. Little data are available on preparations containing less than 30 [mu]g of estrogen, new progestagens or levonorgestrel-releasing intrauterine devices. Hormone replacement therapy increases the risk of VTE by 2 to 3-fold. Transdermal administration may be less thrombogenic than oral administration, while different estrogens and progestagens may carry a different risk. VTE risk is further increased in carriers of inherited thrombophilia. Despite a similar increase in relative risk of thrombosis associated with hormone therapy, absolute risk is lower in fertile women and higher in postmenopausal ones. Universal screening for thrombophilia before prescribing hormone replacement therapy might be cost-effective.
Summary:
Careful evaluation of individual risk factor is warranted before prescribing hormone therapy. Further investigations are needed to establish whether or not newer compounds are safer than older ones with respect to the risk of thrombosis.
Tuesday, July 3, 2007
Four Non-stop Hours Of Travel Doubles DVT Risk
Four Non-stop Hours Of Travel Doubles DVT Risk
01 Jul 2007
Regardless of whether a passenger is traveling by plane, bus or car, after four hours of continuous seated travel, the risk of developing Deep Vein Thrombosis (DVT) doubles, says the World Health Organization (WHO). However, the absolute risk, at 1 in every 6,000 passengers, is low.
WHO also stated that taking two or more flights in succession or over a short period also raised the risk of developing DVT. The main reason is that after a long flight the risk takes about four weeks to wear off.
The two most common manifestations of developing venous thromboembolism (VTE) are deep vein thrombosis (DVT) and pulmonary embolism. DVT is a condition in which a thrombus, or a blood clot develops in a deep vein - generally in the lower leg. The patient might feel pain and tenderness and notice a swelling around the affected area. DVT can be treated. When associated with thromboembolism DVT can be life-threatening.
Thromboembolism is when a DVT blood clot breaks loose and becomes lodged in the lung and blocks blood flow - what is known as pulmonary embolism. With pulmonary embolism the patient may feel chest pains and experience breathing difficulties. If left untreated VTO can lead to death.
For car, plane and bus passengers to run a higher risk of DVT during long trips, they need to remain seated and immobile.
Other factors that may influence VTE risk during long trips:
Obesity
Being taller than 1.9 meters (nearly 6ft 3 inches)
Being shorter than 1.6 meters (5ft 3 inches)
Oral contraceptive use
Inherited blood disorders leading to increased clotting tendency
Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Non-communicable Disease and Mental Health, said "The study does confirm that there is an increased risk of venous thromboembolism during travel where the passenger is seated and immobile for over four hours, whether in a plane, train, bus or car. However, it is important to remember that the risk of developing VTE when travelling remains relatively low".
Although this study did not investigate preventive measures against DVT and VTE, experts recommend passengers observe the following tips:
Exercise your calf muscles with up-and-down movements of the feet at the ankle joints. This encourages blood flow in the calf muscle veins - which in turn reduces blood stagnation.
Avoid wearing tight clothing when you travel
There are special socks you can wear. Many airlines supply them; you can also buy them at most airports and several pharmacies.
WRIGHT project report
Written by: Christian Nordqvist
Editor: Medical News Today
Copyright: Medical News Today
01 Jul 2007
Regardless of whether a passenger is traveling by plane, bus or car, after four hours of continuous seated travel, the risk of developing Deep Vein Thrombosis (DVT) doubles, says the World Health Organization (WHO). However, the absolute risk, at 1 in every 6,000 passengers, is low.
WHO also stated that taking two or more flights in succession or over a short period also raised the risk of developing DVT. The main reason is that after a long flight the risk takes about four weeks to wear off.
The two most common manifestations of developing venous thromboembolism (VTE) are deep vein thrombosis (DVT) and pulmonary embolism. DVT is a condition in which a thrombus, or a blood clot develops in a deep vein - generally in the lower leg. The patient might feel pain and tenderness and notice a swelling around the affected area. DVT can be treated. When associated with thromboembolism DVT can be life-threatening.
Thromboembolism is when a DVT blood clot breaks loose and becomes lodged in the lung and blocks blood flow - what is known as pulmonary embolism. With pulmonary embolism the patient may feel chest pains and experience breathing difficulties. If left untreated VTO can lead to death.
For car, plane and bus passengers to run a higher risk of DVT during long trips, they need to remain seated and immobile.
Other factors that may influence VTE risk during long trips:
Obesity
Being taller than 1.9 meters (nearly 6ft 3 inches)
Being shorter than 1.6 meters (5ft 3 inches)
Oral contraceptive use
Inherited blood disorders leading to increased clotting tendency
Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Non-communicable Disease and Mental Health, said "The study does confirm that there is an increased risk of venous thromboembolism during travel where the passenger is seated and immobile for over four hours, whether in a plane, train, bus or car. However, it is important to remember that the risk of developing VTE when travelling remains relatively low".
Although this study did not investigate preventive measures against DVT and VTE, experts recommend passengers observe the following tips:
Exercise your calf muscles with up-and-down movements of the feet at the ankle joints. This encourages blood flow in the calf muscle veins - which in turn reduces blood stagnation.
Avoid wearing tight clothing when you travel
There are special socks you can wear. Many airlines supply them; you can also buy them at most airports and several pharmacies.
WRIGHT project report
Written by: Christian Nordqvist
Editor: Medical News Today
Copyright: Medical News Today
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