The Interplay of Race/Ethnicity and Obesity on the Incidence of Venous Thromboembolism

Kelechi O. Weze, Olufunmilayo H. Obisesan, Zeina A. Dardari, Miguel Cainzos-Achirica, Omar Dzaye, Garth Graham, Michael D. Miedema, Joseph Yeboah, Andrew P. DeFilippis, Khurram Nasir, Michael J. Blaha, Albert D. Osei

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Introduction: Factors predisposing asymptomatic individuals within the community to venous thromboembolism are not fully understood. This study characterizes the incidence and determinants of venous thromboembolism among the Multiethnic Study of Atherosclerosis cohort with a focus on race/ethnicity and obesity. Methods: This study (analyzed in 2020–2021) used the Multiethnic Study of Atherosclerosis cohort (2000–2017), which included participants with diverse ethnic/racial backgrounds aged 45–84 years without cardiovascular disease at baseline. The primary endpoint was time to diagnosis of venous thromboembolism defined using International Classification of Diseases codes (415, 451, 453, 126, 180, and 182). Multivariable-adjusted hazard ratios of the predictors of venous thromboembolism were calculated with a focus on the interaction between obesity and race/ethnicity categories. Results: Over a median follow-up period of 14 years, 233 individuals developed venous thromboembolism. Incidence rates (per 1,000 person-years) varied across racial/ethnic groups with the highest incidence among Black (4.02) followed by White (2.98), Hispanic (2.08), and Chinese (0.79) participants. There was a stepwise increase in the incidence rate of venous thromboembolism with increasing BMI regardless of race/ethnicity: normal (1.95), overweight (2.52), obese (3.63), and morbidly obese (4.55). The association between BMI and venous thromboembolism was strongest among non-White women with the highest incidence rate for obese (4.8) compared with non-obese (1.6). The interaction among obesity, gender, and race was statistically significant (p=0.01) in non-White obese women. Risk of venous thromboembolism increased with age for all race/ethnicities. Conclusions: This study finds that obesity may confer an increased risk for venous thromboembolism among non-White women compared with other groups—White men, White women, and non-White men.

Original languageEnglish (US)
Pages (from-to)e11-e20
JournalAmerican Journal of Preventive Medicine
Issue number1
StatePublished - Jul 2022


  • Atherosclerosis
  • Ethnicity
  • Female
  • Humans
  • Incidence
  • Male
  • Obesity, Morbid
  • Risk Factors
  • Venous Thromboembolism/diagnosis
  • White People

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology


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