Association of physical activity and recurrent venous thromboembolism

Background: Preventing recurrent venous thromboembolism (VTE) will reduce further physical decline and fatalities among patients who have experienced an incident VTE. Understanding the role of moderate to vigorous physical activity (MVPA) in relation to VTE recurrence risk could help inform behavioral health recommendations. Methods: The Heart and Vascular Health (HVH) study was set in a large integrated healthcare system with detailed medical and pharmaceutical records. The HVH study identified adults with an incident VTE between January 2002 and December 2010; an inception cohort was formed from these cases and adults were followed for a first recurrent VTE through December 2014. Information on usual MVPA pre-incident event was self-reported for 1381 adults via telephone interviews (TI) and MVPA was calculated in metabolic equivalent (MET) hours (h) per week. Results: During follow-up (median=5.23 years), 288 (20.9%) individuals developed a recurrent VTE. Using adjusted Cox proportional hazards models, we found no evidence of an association between any MVPA compared to none in relation to VTE recurrence risk (HRadj=1.24, [95% CI: 0.80, 1.91]). Our primary analyses of any MVPA in continuous MET h/week showed no evidence of an association between continuous MVPA and VTE recurrence risk (HRadj=1.00, [95% CI: 0.98, 1.03]), nor evidence of an association of MVPA in quartiles (p-trend=0.62). Secondary analyses of MET-h/week of PA by intensity also showed no evidence of an association of moderate PA (HRadj=1.00, [95% CI: 0.97, 1.03]) or vigorous PA (HRadj=1.03, [95% CI: 0.99, 1.08]) with recurrent VTE risk. Conclusions: In a cohort of adults with an incident VTE, energy expenditure in any MVPA and separately, within moderate and vigorous intensities of PA, was not associated with risk of recurrent VTE.