Blood clot risk on oestrogen measured

The Factor V Leiden gene can combine with other factors to place women at risk when using oestrogen-based drugs, according to a new study.

It is already known that multimorbidity – the co-occurrence of two or more chronic conditions – oestrogen use, and Factor V Leiden are independent risk factors for venous thromboembolism, the researchers say.

Dr Emma Magavern of Queen Mary University of London, UK, and colleagues looked at the risk of all three together.

The team used figures on 20,048 women in the ongoing Genes & Health British-South Asian cohort.

Overall, 30% of the women were prescribed oestrogens, 3% were carriers of the Factor V Leiden gene mutation, and 2.2% had a venous thromboembolism.

Analysis showed that the risk of venous thromboembolism was increased for women with obesity, hypertension, dyslipidaemia, or chronic kidney disease, and with oestrogen use, and the Factor V Leiden gene mutation.

Findings appear in iScience. The authors write: “Exogenous oestrogens are commonly prescribed to women. Multi-morbidity and the Factor V Leiden gene mutation compound risk of venous thromboembolism with oestrogen use.

“This is important for women in deprived populations with high multi-morbidity burden.”

Dr Magavern said: “Many women will take oestrogen at some point in their lifetime. Overall, this is very safe and there are far more positives to taking it than negatives when it’s prescribed.

“But these women may not be aware of the combined risk of their genetics and overall health and how it affects their risk of developing a blood clot, which could be life-threatening for some individuals.

“It’s important that women have all the information they need to make an informed choice. While our results are important for women everywhere, they are especially relevant for South Asian women with multiple existing health conditions.”

Magavern, E. F. et al. Factor V Leiden, estrogen, and multimorbidity association with venous thromboembolism in a British-South Asian cohort. iScience 31 August 2023; doi: 10.1016/j.isci.2023.107795


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