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Lookup NU author(s): Dr Dexter CanoyORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. Aims Evidence for the effect of elevated blood pressure (BP) on the risk of venous thromboembolism (VTE) has been conflicting. We sought to assess the association between systolic BP and the risk of VTE. Methods and results Three complementary studies comprising an observational cohort analysis, a one-sample and two-sample Mendelian randomization were conducted using data from 5 588 280 patients registered in the Clinical Practice Research Datalink (CPRD) dataset and 432 173 UK Biobank participants with valid genetic data. Summary statistics of International Network on Venous Thrombosis genome-wide association meta-analysis was used for two-sample Mendelian randomization. The primary outcome was the first occurrence of VTE event, identified from hospital discharge reports, death registers, and/or primary care records. In the CPRD cohort, 104 017(1.9%) patients had a first diagnosis of VTE during the 9.6-year follow-up. Each 20 mmHg increase in systolic BP was associated with a 7% lower risk of VTE [hazard ratio: 0.93, 95% confidence interval (CI): (0.92–0.94)]. Statistically significant interactions were found for sex and body mass index, but not for age and subtype of VTE (pulmonary embolism and deep venous thrombosis). Mendelian randomization studies provided strong evidence for the association between systolic BP and VTE, both in the one-sample [odds ratio (OR): 0.69, (95% CI: 0.57–0.83)] and two-sample analyses [OR: 0.80, 95% CI: (0.70–0.92)]. Conclusion We found an increased risk of VTE with lower BP, and this association was independently confirmed in two Mendelian randomization analyses. The benefits of BP reduction are likely to outweigh the harms in most patient groups, but in people with predisposing factors for VTE, further BP reduction should be made cautiously.
Author(s): Nazarzadeh M, Bidel Z, Mohseni H, Canoy D, Pinho-Gomes A-C, Hassaine A, Dehghan A, Tregouet D-A, Smith NL, Rahimi K
Publication type: Article
Publication status: Published
Journal: Cardiovascular Research
Year: 2023
Volume: 119
Issue: 3
Pages: 835-842
Print publication date: 01/03/2023
Online publication date: 29/08/2022
Acceptance date: 26/07/2022
Date deposited: 01/03/2024
ISSN (print): 0008-6363
ISSN (electronic): 1755-3245
Publisher: Oxford University Press
URL: https://doi.org/10.1093/cvr/cvac135
DOI: 10.1093/cvr/cvac135
Data Access Statement: Data can be obtained directly from CPRD subject to the custodian’s policies for scientific, data governance, and financial approvals (see www.cprd.com). All bona fide researchers can apply to use the UK Biobank data set for health-related research. A guide to access is also provided on the UK Biobank website (see www.ukbiobank.ac.uk).
PubMed id: 36031541
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