Background: Sex-related differences in incidence rate of venous thromboembolism (VTE) have been reported. It is unclear whether these differences reflect sex-related differences in the incidence of deep venous thrombosis (DVT), pulmonary embolism (PE) or both and to which extent the differences are mediated by known risk factors for VTE.
Objective: To compare the incidence of DVT and PE between middle-aged men and women.
Methods: We computed sex-specific incidences of VTE, DVT and PE and estimated the crude and adjusted incidence rate ratios (IRR) of VTE, DVT and PE using Cox regression for men versus women participating in the prospective study Diet, Cancer and Health. We controlled for body mass index, body height, leisure-time physical activity and smoking dose.
Results: We verified 641 VTE events during a median follow-up time of 10 years. The overall incidence of VTE was 1.15 [95%CI: 1.07-1.25] per thousand person years; it was higher for men than women (crude IRR: 1.55 [95%CI: 1.32-1.82]). The adjusted IRR for DVT was 1.06 [95%CI: 0.75-1.50] and for PE 0.60 [95%CI: 0.41-1.18] for men versus women. The higher rate among men appeared to be mediated mainly by body height.
Conclusions: In this middle-aged population, men experienced a higher incidence of VTE due to a higher incidence of DVT. The higher incidence among men appeared to be mediated by body height. Adjusted for body height, male sex was not associated with an excess risk of either VTE or DVT but the risk of PE was notably lower compared with women.