What is the clinical evidence from this study?

Study design: Cohort. Population: Venous thromboembolism (n=18240). Intervention: Change in self-rated health (poor to very good/excellent) vs. Stable poor self-rated health. Primary outcome: Incident venous thromboembolism (VTE) in women (HR 0.46, 95% CI 0.28-0.74).

January 24, 2024Open Access

Association between changed self-rated health and the risk of venous thromboembolism in Malmö Preventive Program: a cohort study

Key Result

Among women, a change in self-rated health from poor to very good/excellent was associated with a significantly reduced risk of incident venous thromboembolism (HR 0.46) compared to stable poor health.

Study Design

Type

Cohort (n=18,240)

Multicenter

Structured PICO

Does change in self-rated health affect the risk of incident venous thromboembolism in men and women?

Population

13,003 adults (7,937 men and 5,066 women) aged 35-70 from the Malmö Preventive Program in Sweden, without prevalent disease associated with increased risk for VTE before re-examination.

Intervention

Change in self-rated health (SRH) from baseline (1974-1992) to re-examination (2002-2006), categorized as good to very good/excellent, good to poor/fair, or poor to very good/excellent.

Comparator

Stable poor self-rated health (poor at both baseline and re-examination).

Outcome

Incident venous thromboembolism (VTE) during follow-up from re-examination.hard clinical

A good self-rated health anytime during life is associated with a lower risk of incident venous thromboembolism in women, but not in men.

Main Result

Effect estimate: HR 0.46 (95% CI 0.28-0.74)

Limitations

Lack of socioeconomic data or hospitalizations
Lack of psychological status assessment and personality traits
Variation in self-rated health assessment questions between baseline and re-examination

Abstract

Poor self-rated health (SRH) is associated with incident arterial cardiovascular disease in both sexes. Studies on the association between SRH and incident venous thromboembolism (VTE) show divergent results in women and no association in men. This study focuses on the association between change in SRH and incident VTE in a cohort of 11,558 men and 6682 women who underwent a baseline examination and assessment of SRH between 1974 and 1992 and a re-examination in 2002-2006. To investigate if changes in SRH over time affect the risk of incident VTE in men and women. During a follow-up time from the re-examination of more than 16 years, there was a lower risk for incident VTE among women if SRH changed from poor at baseline to very good/excellent (HR 0.46, 95% CI 0.28; 0.74) at the re-examination. Stable good SRH (good to very good/excellent at the re-examination, HR 0.60, 95% CI 0.42; 0.89), or change from good SRH at baseline into poor/fair at the re-examination (HR 0.68, 95% CI 0.51; 0.90) were all significantly associated with a reduced risk for VTE. All comparisons were done with the group with stable poor SRH. This pattern was not found among men. Regardless of a decreased or increased SRH during life, having an SRH of very good/excellent at any time point seems to be associated with a decreased risk of VTE among women.

Bookmark

View Full Paper