1. Home>
2. Specialties>
3. Women's Health>
4. Summary and Comment

Risk Factors for PE in Women

We already have many reasons to avoid smoking and to control obesity and hypertension. Now we have another: pulmonary embolism.

Investigators used data from the Nurses' Health Study to identify risk factors for PE. Over 112,000 women aged 30 to 55 in 1976 were followed for 16 years by questionnaire, family reports for those who died, and review of medical records. Overall, there were 280 cases of PE: 115 were considered secondary to cancer, trauma, surgery, or immobilization; 125 primary cases were not attributable to any of these factors; and 40 had insufficient data to determine the cause.

In a multivariate analysis, smoking, obesity, and hypertension independently predicted PE. Relative risks were 1.9 (95% CI, 0.9 to 3.7) in women currently smoking 25 to 34 cigarettes a day, 3.3 (1.7-6.5) in heavier smokers, 2.9 (1.5-5.4) in obese women, and 1.9 (1.2-2.8) in hypertensive women. The predictors had similar strength in the subgroup of women with primary PE. Cholesterol elevations and diabetes did not increase the risk.

Comment: Pulmonary embolism is most likely to occur with trauma, cancer, surgery, or immobilization. This study demonstrates several important, reversible factors that contribute to PE in these settings, and also in women without known risk factors. Inherited predispositions to thrombosis, such as factor V Leiden, may also play a role not determined here.

— W Levinson

Published in Journal Watch Women's Health May 1, 1997

Citation(s):

Goldhaber SZ et al. A prospective study of risk factors for pulmonary embolism in women. JAMA 1997 Feb 26 277 642-645.

• Medline abstract (Free)