Risk of pulmonary embolism and/or deep venous thrombosis in Asian/Americans

Several reports from Asian countries suggest a low prevalence of pulmonary embolism (PE) and deep venous thrombosis (DVT] in Asians, and sparse US dat a show that a slightly higher prevalence of PE/DVT in "nonwhites" than in w hites is evident in all geographic regions except the Pacific region (Calif ornia, Oregon, and Washington) where "nonwhites" include a larger proportio n of Asians and Hispanics than in other US locations. We prospectively stud ied PE/DVT hospitalizations in 128,934 persons in relation to traits determ ined at health examinations in 1978 to 1985. Through 1994, 337 persons were subsequently hospitalized for PE and/or DVT (far PE first, n = 206), Cox p roportionol-hazards models with 9 covariates were used. In multivariate mod els, the following RRs (95% confidence intervals) were found for PE/DVT com bined: black! white = 1.1 (0.4 to 1.4); Hispanic/white = 0.7 (0.3 to 1.5); and Asian/white = 0.2 (0.1 to 0.5; p = 0.002), The lower risk of Asians was present in each sex and for persons first hospitalized For either PE or DV T, Covariates with significant positive relations to risk were age, male se x, body mass index, and a composite coronary disease risk/symptom variable; covariates not significantly related were education, marital status, smoki ng, and alcohol, These data suggest that Asians have very low risk of PE/DV T, which may account for US geographic variations in white/non-white risk d ifferences. Possible explanations include the absence of hazardous mutation s or unspecified PE/DVT protective traits in Asians. (C) 2000 by Excerpta M edica, Inc.