Serum 25-hydroxyvitamin D and risk of venous thromboembolism: the Atherosclerosis Risk in Communities (ARIC) Study

J Thromb Haemost. 2014 Sep;12(9):1455-60. doi: 10.1111/jth.12665. Epub 2014 Aug 11.


Background: Some evidence suggests that an inadequate vitamin D level may increase the risk for atherosclerotic cardiovascular disease. Whether a low vitamin D level plays a role in venous thromboembolism (VTE), that is, venous thrombosis and pulmonary embolism, is largely unexplored.

Objectives: We tested prospectively, in the Atherosclerosis Risk in Communities (ARIC) cohort, whether the serum level of 25-hydroxyvitamin D (25[OH]D) is inversely associated with VTE incidence, and whether it partly explains the African American excess of VTE in the ARIC Study.

Patients and methods: We measured 25(OH)D by using mass spectroscopy in stored samples of 12 752 ARIC Study participants, and followed them over a median of 19.7 years (1990-1992 to 2011) for the incidence of VTE (n = 537).

Results: The seasonally adjusted 25(OH)D level was not associated with VTE incidence. In a model adjusted for age, race, sex, hormone replacement therapy, and body mass index, the hazard ratios of VTE across 25(OH)D quintiles 5 (high) to 1 (low) were: 1 (ref.), 0.84 (95% confidence interval [CI] 0.65-1.08), 0.88 (95% CI 0.68-1.13), 1.04 (95% CI 0.78-1.38), and 0.90 (95% CI 0.64-1.27). The lowest 25(OH)D quintile contained 59% African Americans, whereas the highest quintile contained 7% African Americans. However, lower 25(OH)D levels explained little of the 63% greater VTE risk of African Americans over whites in this cohort.

Conclusions: A low 25(OH)D level was not a risk factor for VTE in this prospective study. However, the totality of the literature (three studies) suggests that a low 25(OH)D level might modestly increase VTE risk in whites, but this needs further confirmation.

Keywords: prospective studies; pulmonary embolism; risk factors; venous thrombosis; vitamin D.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Atherosclerosis / blood*
  • Atherosclerosis / ethnology
  • Black or African American
  • Female
  • Humans
  • Incidence
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Pulmonary Embolism / blood*
  • Pulmonary Embolism / ethnology
  • Risk Factors
  • Seasons
  • Treatment Outcome
  • United States
  • Venous Thrombosis / blood*
  • Venous Thrombosis / ethnology
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood


  • Vitamin D
  • 25-hydroxyvitamin D