Lifestyle Disorders: Venous Thromboembolism

Lifestyle Disorders: Venous Thromboembolism (VTE)

Venous Thromboembolism (VTE) is a condition in which blood clots form in the veins. It encompasses two related conditions: Deep Vein Thrombosis (DVT) — where clots form in the deep veins, usually in the legs — and Pulmonary Embolism (PE) — where a clot breaks off and travels to the lungs. VTE is one of the leading causes of preventable hospital deaths worldwide and is increasingly recognised as a lifestyle disorder with a significant genetic component.

Symptoms

• DVT: Swelling, pain, tenderness, and redness in the affected leg; warmth over the clot area

• PE: Sudden shortness of breath, chest pain (especially on breathing in), rapid heart rate, coughing up blood, dizziness or fainting

• Many cases of DVT are asymptomatic and are only discovered when PE occurs

Risk Factors

• Prolonged immobility — long flights, bed rest, sedentary lifestyle

• Surgery or hospitalisation

• Obesity

• Smoking

• Oral contraceptive use or hormone replacement therapy

• Pregnancy and the postpartum period

• Cancer and cancer treatments

• Family history of VTE

The Genetic Component

Inherited thrombophilias — genetic conditions that increase the tendency of blood to clot — are present in a significant proportion of VTE patients. The most common include:

• Factor V Leiden mutation: The most common inherited thrombophilia, increasing VTE risk 4–8 times in heterozygous carriers and 80 times in homozygous carriers

• Prothrombin G20210A mutation: Increases prothrombin levels and VTE risk 2–3 times

• MTHFR variants: Associated with elevated homocysteine levels, which can damage blood vessel walls and promote clotting

• Protein C and Protein S deficiency: Inherited deficiencies of these natural anticoagulants increase clotting risk

• Antithrombin deficiency: One of the highest-risk inherited thrombophilias

Knowing your inherited thrombophilia status is particularly important before surgery, pregnancy, or starting hormonal contraception — all situations where VTE risk is already elevated.

Prevention and Management

• Stay active — avoid prolonged sitting or immobility

• Stay hydrated, especially during long flights

• Maintain a healthy weight

• Avoid smoking

• Wear compression stockings if at risk

• Anticoagulant therapy (blood thinners) for those at high risk or with a history of VTE

• Genetic testing to identify inherited thrombophilias, especially with a family history of VTE