摘要：Objectives. We sought to document incidence, case-fatality, and recurrence rates of venous thromboembolism (VTE) in women and to explore the relationship of demographic, lifestyle, and anthropometric factors to VTE incidence. Methods. Data from participants aged 55 to 69 years in the Iowa Women's Health Study were linked to Medicare data for 1986 through 2004 (n = 40 377) to identify hospitalized VTE patients. Results. A total of 2137 women developed VTE, yielding an incidence rate of 4.04 per 1000 person-years. The 28-day case-fatality rate was 7.7%, and the 1-year recurrence rate was 3.4%. Educational attainment, physical activity, and age at menopause were inversely associated with VTE. Risk of secondary (particularly cancer-related) VTE was higher among smokers than among those who had never smoked. Body mass index, waist circumference, waist-to-hip ratio, height, and diabetes were positively associated with VTE risk. Hormone replacement therapy use was associated with increased risk of idiopathic VTE. Conclusions. VTE is a significant source of morbidity and mortality in older women. Risk was elevated among women who were smokers, physically inactive, overweight, and diabetic, indicating that lifestyle contributes to VTE risk. Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism (VTE), are major sources of morbidity and mortality. 1 Definition of the public health burden of this condition remains incomplete because VTE incidence, case-fatality, and recurrence rates have not been fully documented. Furthermore, few studies have prospectively evaluated risk factors for VTE. Data from 41 836 participants enrolled in the Iowa Women's Health Study (IWHS), who have been followed for nearly 20 years, were recently linked to Medicare enrollment and claims data. This linkage allowed us to examine VTE incidence, case-fatality, and recurrence rates among elderly women and to explore the prospective association between demographic and lifestyle factors and VTE incidence. We hypothesized that VTE risk would be elevated among women who were older, less well-educated, obese, taller, and physically inactive, as well as among those who used hormone replacement therapy, were older at menopause, were of higher parity, or had diabetes. We predicted that no association would be observed with cigarette smoking. In addition, we hypothesized that risk factors would differ according to whether VTE was idiopathic (unprovoked) or secondary (associated with a comorbid clinical condition known to cause VTE).
