Tall, Overweight Individuals at Higher Risk for Blood Clots and Other Complications

Tall, overweight men are five times more at risk to develop potentially dangerous blood clots, says a recent study published in the Journal of the American Heart Association. Every year in the U.S., more than 275,000 people are hospitalized for deep vein clots or pulmonary embolism. Tall, obese men are particularly at risk for venous thromboembolism (VTE), a condition that starts when a clot occurs in a deep vein – such as a leg vein – and breaks off and travels to the lungs, causing a pulmonary embolism. When the clot travels to the lungs it can cut off blood circulation, cause dizziness, shortness of breath, and sometimes death.

“In tall people the blood must be pumped a longer distance by the calf-muscle pump, which may cause reduced flow in the legs and thereby raise the risk of clotting,” said senior study author Dr. Sigrid K. Braekkan. “Understanding and preventing VTE is important because even the first occurrence may be fatal. Obesity, in combination with other VTE risk factors, has been shown to substantially increase the risk, so we wanted to assess the combined effects of tall stature and obesity.”

Tall, obese women are close to three times more at risk for VTE, the study showed. The research team collected data from more than 26,000 people from 1994 to 2007. “Obesity is also linked to a state of constant low-grade inflammation, and inflammation may render blood more susceptible to clotting,” Braekkan said. Doctors should be mindful of patients with these risk factors as obesity elevates pressure in the abdomen, thereby potentially decreasing the ability of blood to flow to the lower extremities.

The American Heart Association recently released new guidelines for complicated, serious cases involving blood clots. The guidelines will help doctors and hospitalists go after more aggressive treatment in certain populations. “For patients, the new guidelines should make a difference in outcomes,” said Dr. M. Sean McMurtry. “Ideally, it will lead to better care. While most patients don’t die from pulmonary embolism, when you start talking massive pulmonary embolism, it can have a significant mortality rate.”

The new guidelines promote aggressive treatment, such as clot-busting drugs, catheters to open up blood vessels, and surgery to remove clots and insert vein filters. Deep vein thrombosis (DVT) oftentimes is caused by extended bedrest, sitting for long periods, recent surgery, pregnancy, taking birth control pills or hormones, fractures, smoking, cancer, and obesity, the National Institutes of Health states. There are many effective treatments to lessen DVT and prevent a pulmonary embolism.

External compression devices can be a good complement to a doctor’s course of treatment against DVT, and certain machines can be used with obese patients. Compression therapy helps stimulate the venous system as it increases the volume and velocity of flow from superficial veins up through the deep veins, and decreases venous stasis, blood pooling, and venous congestion. Mechanical compression therapy decreases blood vessel distension and helps lower the risk of injury to the endothelium tissue. Overall, this therapy enhances fibrinolysis, which assists in activating anti-clotting factors.