Preventive measures against deep vein thrombosis (DVT) begin at home with behavioral changes, continue at work with more body movement, and hospitalized patients should be assessed for risk factors for developing deep vein thrombosis, physicians have recommended. To help apply recommendations to achieve large-scale risk reduction for DVT, the International Society on Thrombosis and Haemostasis (ISTH) has been running a global campaign known as World Thrombosis Day (WTD), held annually on 13 October. For this year’s occasion, ISTH launched the “60 For 60 Fitness Challenge” to promote exercising “every 60 minutes with 60 seconds of muscle movement”.
Prof. Lee Lai Heng, Senior Consultant, Department of Haematology, Singapore General Hospital, said that people were becoming increasingly prone to a sedentary lifestyle as ever-advancing technology kept furnishing them with daily-life conveniences as well as indulgence in social media activities and computer games. Inadequate body movement could result in blood clots forming in blood vessels to the extent of clogging, culminating in thrombosis, along with the possibility of severe complications. There has been reports of people, who are otherwise healthy, developing deep vein thrombosis after prolonged sitting working or gaming at the computer as well as after marathon mahjong games.
Major risk factors predisposing to development of DVT include:
- Prolonged immobility, whether in or out of hospital. Blood circulation in the lower limbs slows down when the body remains immobile, eg during prolonged bed rest, being seated for long hours, especially in an awkward posture, resulting in increased susceptibility to blood-clot formation.
- Hospitalization and major surgery: More than 60% of thrombosis cases were patients who had been hospitalized for too long or afflicted by vascular trauma after surgery. Their limited movement puts them at risk.
- Hospitalization and Severe illnesses: Patients with debilitative heart and lung diseases and those with severe infections and inflammatory conditions are prone to developing DVT during hospitalization.
- Cancer and cancer treatment – Compared with healthy people, cancer patients are 4 times more likely to develop thrombosis, which may then hinder their cancer treatment
- Oral contraceptives, hormone replacement and pregnancy: Estrogen-based oral contraceptives and medications increase the levels of clotting factors, thus predisposing to blood clots. Pregnant women are also at increased risk, as their blood becomes thickened throughout their pregnancy and the first 6 weeks after childbirth. In the general population, risks of VTE in healthy women who are on hormonal medications or pregnant is low; but in the presence of other additional risk actors, the VTE risks increases substantially.
- Cigarette’s smoking and obesity are well established risk factors for atherosclerotic diseases have also been found to increase the risk of venous thromboembolism.
- Hereditary cause People with conditions such as antithrombin deficiency, protein C and protein S deficiency which are genetic predisposition with increased blood clotting abilities are predisposed to with venous thromboembolism (VTE). Other genetic predisposition such as Factor V Leiden and Prothrombin gene mutation which are common in the west are very rare here. There are also other hereditary predisposition towards VE which may not be well described, so if there is a family history of VTE, one must be careful to apply preventive measures in high risk situations.
“Preventive measures are the best approach for thrombosis risk reduction, and the easiest for most people. Simply avoid risk behaviors. Keep a healthy life style and body weight. Don’t smoke. Don’t sit still for too long. Move you body about. Set aside regular time for exercises. Ask a doctor to assess your risk periodically if you need to keep a watchful eye on known risk exposure. Awareness of risk factors is critical for effective preparation, should it be necessary,” said Dr. Lee Lai Heng.
Because thrombosis would continue to be a silent killer, ISTH found it imperative to establish WTD, now observed globally on 13 October, to raise awareness of the disease. Celebrating its 10th anniversary, the theme of this year’s campaign, Move Against Thrombosis, encourages people to get up and move to increase blood circulation, which can help lower the risk of blood clots. ISTH also came up with the “60 For 60 Fitness Challenge”, hoping to see everyone spend just 60 seconds moving somehow for every 60 minutes of being largely sedentary: walk around the place at hand, dance to favorite tunes, perform hip circles, to name a few examples, all of which constitute preventive measures against thrombosis.
