Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts
BACKGROUND—Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope. METHODS AND RESULTS—We ascertained VTE from 3 prospecti...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2014-04, Vol.129 (14), p.1502-1509 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | Zakai, Neil A McClure, Leslie A Judd, Suzanne E Safford, Monika M Folsom, Aaron R Lutsey, Pamela L Cushman, Mary |
| description | BACKGROUND—Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope.
METHODS AND RESULTS—We ascertained VTE from 3 prospective studiesthe Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Reasons for Geographic and Racial Differences in Stroke study (REGARDS). We tested the association of race with VTE using Cox proportional hazard models adjusted for VTE risk factors. Over 438 090 person-years, 916 incident VTE events (302 in blacks) occurred in 51 149 individuals (17 318 blacks) who were followed up. In risk factor–adjusted models, blacks had a higher rate of VTE than whites in the CHS (hazard ratio, 1.81; 95% confidence interval, 1.20–2.73) but not ARIC (hazard ratio, 1.21; 95% confidence interval, 0.96–1.54). In REGARDS, there was a significant region-by-race interaction (P=0.01)Blacks in the Southeast had a significantly higher rate of VTE than blacks in the rest of the United States (hazard ratio, 1.63; 95% confidence interval, 1.08–2.48) that was not seen in whites (hazard ratio, 0.83; 95% confidence interval, 0.61–1.14).
CONCLUSIONS—The association of race with VTE differed in each cohort, which may reflect the different time periods of the studies or different regional rates of VTE. Further studies of environmental and genetic risk factors for VTE are needed to determine which underlie racial and perhaps regional differences in VTE. |
| doi_str_mv | 10.1161/CIRCULATIONAHA.113.006472 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1514430760</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1514430760</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5182-62823e823fa15f7eed135a90eb3719e2ea8234e93622eceef9240ceda845eab3</originalsourceid><addsrcrecordid>eNqNkMlOwzAQhi0EgrK8AgoHJC4Br1kOHKqwVapAKoULh8h1JsTgxMVOhXh7jFJA3Dj8Gs3MN4t-hI4IPiUkIWfFZFY8TMfzyd3t-GYcauwU44SndAONiKA85oLlm2iEMc7jlFG6g3a9fwlpwlKxjXYoFzjLaDJCTzOptDSR7KpoBs_adiG50HUNDjoFPtJd9AidXflo3jjbLiwEGe3br07fQPTQ6R6q6L6X_YCzqLCNdb3fR1u1NB4O1nEPza8u58VNPL27nhTjaawEyWic0IwyCKolEXUKUBEmZI5hwVKSAwUZehxyllAKCqDOKccKKplxAXLB9tDJsHbp7NsKfF-22iswRnYQ_i6JIJwznCY4oPmAKme9d1CXS6db6T5Kgssva8u_1oYaKwdrw-zh-sxq0UL1M_ntZQCO14D0SprayU5p_8tlnIhcsMCdD9y7NT04_2pW7-DKBqTpm3888gkVEpZj</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1514430760</pqid></control><display><type>article</type><title>Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Journals@Ovid Complete</source><creator>Zakai, Neil A ; McClure, Leslie A ; Judd, Suzanne E ; Safford, Monika M ; Folsom, Aaron R ; Lutsey, Pamela L ; Cushman, Mary</creator><creatorcontrib>Zakai, Neil A ; McClure, Leslie A ; Judd, Suzanne E ; Safford, Monika M ; Folsom, Aaron R ; Lutsey, Pamela L ; Cushman, Mary</creatorcontrib><description>BACKGROUND—Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope.
METHODS AND RESULTS—We ascertained VTE from 3 prospective studiesthe Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Reasons for Geographic and Racial Differences in Stroke study (REGARDS). We tested the association of race with VTE using Cox proportional hazard models adjusted for VTE risk factors. Over 438 090 person-years, 916 incident VTE events (302 in blacks) occurred in 51 149 individuals (17 318 blacks) who were followed up. In risk factor–adjusted models, blacks had a higher rate of VTE than whites in the CHS (hazard ratio, 1.81; 95% confidence interval, 1.20–2.73) but not ARIC (hazard ratio, 1.21; 95% confidence interval, 0.96–1.54). In REGARDS, there was a significant region-by-race interaction (P=0.01)Blacks in the Southeast had a significantly higher rate of VTE than blacks in the rest of the United States (hazard ratio, 1.63; 95% confidence interval, 1.08–2.48) that was not seen in whites (hazard ratio, 0.83; 95% confidence interval, 0.61–1.14).
CONCLUSIONS—The association of race with VTE differed in each cohort, which may reflect the different time periods of the studies or different regional rates of VTE. Further studies of environmental and genetic risk factors for VTE are needed to determine which underlie racial and perhaps regional differences in VTE.</description><identifier>ISSN: 0009-7322</identifier><identifier>ISSN: 1524-4539</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.113.006472</identifier><identifier>PMID: 24508826</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><subject>Aged ; Biological and medical sciences ; Black People - statistics & numerical data ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cohort Studies ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Humans ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Residence Characteristics - statistics & numerical data ; Risk Factors ; United States - epidemiology ; Venous Thromboembolism - diagnosis ; Venous Thromboembolism - epidemiology ; Venous Thromboembolism - ethnology ; White People - statistics & numerical data</subject><ispartof>Circulation (New York, N.Y.), 2014-04, Vol.129 (14), p.1502-1509</ispartof><rights>2014 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5182-62823e823fa15f7eed135a90eb3719e2ea8234e93622eceef9240ceda845eab3</citedby><cites>FETCH-LOGICAL-c5182-62823e823fa15f7eed135a90eb3719e2ea8234e93622eceef9240ceda845eab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28415953$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24508826$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zakai, Neil A</creatorcontrib><creatorcontrib>McClure, Leslie A</creatorcontrib><creatorcontrib>Judd, Suzanne E</creatorcontrib><creatorcontrib>Safford, Monika M</creatorcontrib><creatorcontrib>Folsom, Aaron R</creatorcontrib><creatorcontrib>Lutsey, Pamela L</creatorcontrib><creatorcontrib>Cushman, Mary</creatorcontrib><title>Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>BACKGROUND—Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope.
METHODS AND RESULTS—We ascertained VTE from 3 prospective studiesthe Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Reasons for Geographic and Racial Differences in Stroke study (REGARDS). We tested the association of race with VTE using Cox proportional hazard models adjusted for VTE risk factors. Over 438 090 person-years, 916 incident VTE events (302 in blacks) occurred in 51 149 individuals (17 318 blacks) who were followed up. In risk factor–adjusted models, blacks had a higher rate of VTE than whites in the CHS (hazard ratio, 1.81; 95% confidence interval, 1.20–2.73) but not ARIC (hazard ratio, 1.21; 95% confidence interval, 0.96–1.54). In REGARDS, there was a significant region-by-race interaction (P=0.01)Blacks in the Southeast had a significantly higher rate of VTE than blacks in the rest of the United States (hazard ratio, 1.63; 95% confidence interval, 1.08–2.48) that was not seen in whites (hazard ratio, 0.83; 95% confidence interval, 0.61–1.14).
CONCLUSIONS—The association of race with VTE differed in each cohort, which may reflect the different time periods of the studies or different regional rates of VTE. Further studies of environmental and genetic risk factors for VTE are needed to determine which underlie racial and perhaps regional differences in VTE.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Black People - statistics & numerical data</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cohort Studies</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Female</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Residence Characteristics - statistics & numerical data</subject><subject>Risk Factors</subject><subject>United States - epidemiology</subject><subject>Venous Thromboembolism - diagnosis</subject><subject>Venous Thromboembolism - epidemiology</subject><subject>Venous Thromboembolism - ethnology</subject><subject>White People - statistics & numerical data</subject><issn>0009-7322</issn><issn>1524-4539</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMlOwzAQhi0EgrK8AgoHJC4Br1kOHKqwVapAKoULh8h1JsTgxMVOhXh7jFJA3Dj8Gs3MN4t-hI4IPiUkIWfFZFY8TMfzyd3t-GYcauwU44SndAONiKA85oLlm2iEMc7jlFG6g3a9fwlpwlKxjXYoFzjLaDJCTzOptDSR7KpoBs_adiG50HUNDjoFPtJd9AidXflo3jjbLiwEGe3br07fQPTQ6R6q6L6X_YCzqLCNdb3fR1u1NB4O1nEPza8u58VNPL27nhTjaawEyWic0IwyCKolEXUKUBEmZI5hwVKSAwUZehxyllAKCqDOKccKKplxAXLB9tDJsHbp7NsKfF-22iswRnYQ_i6JIJwznCY4oPmAKme9d1CXS6db6T5Kgssva8u_1oYaKwdrw-zh-sxq0UL1M_ntZQCO14D0SprayU5p_8tlnIhcsMCdD9y7NT04_2pW7-DKBqTpm3888gkVEpZj</recordid><startdate>20140408</startdate><enddate>20140408</enddate><creator>Zakai, Neil A</creator><creator>McClure, Leslie A</creator><creator>Judd, Suzanne E</creator><creator>Safford, Monika M</creator><creator>Folsom, Aaron R</creator><creator>Lutsey, Pamela L</creator><creator>Cushman, Mary</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140408</creationdate><title>Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts</title><author>Zakai, Neil A ; McClure, Leslie A ; Judd, Suzanne E ; Safford, Monika M ; Folsom, Aaron R ; Lutsey, Pamela L ; Cushman, Mary</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5182-62823e823fa15f7eed135a90eb3719e2ea8234e93622eceef9240ceda845eab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Black People - statistics & numerical data</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cohort Studies</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Female</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Residence Characteristics - statistics & numerical data</topic><topic>Risk Factors</topic><topic>United States - epidemiology</topic><topic>Venous Thromboembolism - diagnosis</topic><topic>Venous Thromboembolism - epidemiology</topic><topic>Venous Thromboembolism - ethnology</topic><topic>White People - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zakai, Neil A</creatorcontrib><creatorcontrib>McClure, Leslie A</creatorcontrib><creatorcontrib>Judd, Suzanne E</creatorcontrib><creatorcontrib>Safford, Monika M</creatorcontrib><creatorcontrib>Folsom, Aaron R</creatorcontrib><creatorcontrib>Lutsey, Pamela L</creatorcontrib><creatorcontrib>Cushman, Mary</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zakai, Neil A</au><au>McClure, Leslie A</au><au>Judd, Suzanne E</au><au>Safford, Monika M</au><au>Folsom, Aaron R</au><au>Lutsey, Pamela L</au><au>Cushman, Mary</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2014-04-08</date><risdate>2014</risdate><volume>129</volume><issue>14</issue><spage>1502</spage><epage>1509</epage><pages>1502-1509</pages><issn>0009-7322</issn><issn>1524-4539</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>BACKGROUND—Blacks are thought to have a higher risk of venous thromboembolism (VTE) than whites. However, prior studies are limited to administrative databases that lack specific information on VTE risk factors or have limited geographic scope.
METHODS AND RESULTS—We ascertained VTE from 3 prospective studiesthe Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Reasons for Geographic and Racial Differences in Stroke study (REGARDS). We tested the association of race with VTE using Cox proportional hazard models adjusted for VTE risk factors. Over 438 090 person-years, 916 incident VTE events (302 in blacks) occurred in 51 149 individuals (17 318 blacks) who were followed up. In risk factor–adjusted models, blacks had a higher rate of VTE than whites in the CHS (hazard ratio, 1.81; 95% confidence interval, 1.20–2.73) but not ARIC (hazard ratio, 1.21; 95% confidence interval, 0.96–1.54). In REGARDS, there was a significant region-by-race interaction (P=0.01)Blacks in the Southeast had a significantly higher rate of VTE than blacks in the rest of the United States (hazard ratio, 1.63; 95% confidence interval, 1.08–2.48) that was not seen in whites (hazard ratio, 0.83; 95% confidence interval, 0.61–1.14).
CONCLUSIONS—The association of race with VTE differed in each cohort, which may reflect the different time periods of the studies or different regional rates of VTE. Further studies of environmental and genetic risk factors for VTE are needed to determine which underlie racial and perhaps regional differences in VTE.</abstract><cop>Hagerstown, MD</cop><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub><pmid>24508826</pmid><doi>10.1161/CIRCULATIONAHA.113.006472</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biological and medical sciences Black People - statistics & numerical data Blood and lymphatic vessels Cardiology. Vascular system Cohort Studies Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Humans Longitudinal Studies Male Medical sciences Middle Aged Prevalence Proportional Hazards Models Prospective Studies Residence Characteristics - statistics & numerical data Risk Factors United States - epidemiology Venous Thromboembolism - diagnosis Venous Thromboembolism - epidemiology Venous Thromboembolism - ethnology White People - statistics & numerical data |
| title | Racial and Regional Differences in Venous Thromboembolism in the United States in 3 Cohorts |
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