Physical activity and risk of venous thromboembolism : systematic review and meta-analysis of prospective cohort studies
Kunutsor, S. K., Mäkikallio, T. H., Seidu, S., de Araújo, C. G. S., Dey, R. S., Blom, A. W., & Laukkanen, J. A. (2020). Physical activity and risk of venous thromboembolism : systematic review and meta-analysis of prospective cohort studies. European Journal of Epidemiology, 35(5), 431-442. https://doi.org/10.1007/s10654-019-00579-2
Published inEuropean Journal of Epidemiology
© 2020 the Authors
The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and venous thromboembolism (VTE) is divergent. We conducted a systematic review and meta-analysis of published observational prospective cohort studies evaluating the associations of physical activity with VTE risk. MEDLINE, Embase, Web of Science, and manual search of relevant bibliographies were systematically searched until 26 February 2019. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus minimal amount of physical activity groups were pooled using random effects meta-analysis. Twelve articles based on 14 unique prospective cohort studies comprising of 1,286,295 participants and 23,753 VTE events were eligible. The pooled fully-adjusted RR (95% CI) of VTE comparing the most physically active versus the least physically active groups was 0.87 (0.79–0.95). In pooled analysis of 10 studies (288,043 participants and 7069 VTE events) that reported risk estimates not adjusted for body mass index (BMI), the RR (95% CI) of VTE was 0.81 (0.70–0.93). The associations did not vary by geographical location, age, sex, BMI, and methodological quality of studies. There was no evidence of publication bias among contributing studies. Pooled observational prospective cohort studies support an association between regular physical activity and low incidence of VTE. The relationship does not appear to be mediated or confounded by BMI. ...
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Additional information about fundingThis study was supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol (BRC-1215-20011). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. THM and SKK acknowledge support from the Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland via the Finnish Governmental Research Funding (VTR). SS acknowledges support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care – East Midlands (NIHR CLAHRC – EM), the Leicester Clinical Trials Unit and the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester. ...
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