The role of ethnicity, age and gender in venous thromboembolism Martina Montagnana Æ Emmanuel J. Favaloro Æ Massimo Franchini Æ Gian Cesare Guidi Æ Giuseppe Lippi Published online: 18 June 2009 Ó Springer Science+Business Media, LLC 2009 Abstract Venous thromboembolism, including both deep venous thrombosis and pulmonary embolism, is the leading cause of preventable in-hospital mortality. In the inexorable progress towards individualization of risk and personalized medicine, several congenital and acquired risk factors have been identified. However, the influence of some demo- graphical variables, especially ethnicity, age and gender, has largely been under appreciated. Although the incidence of venous thromboembolism varies widely among diverse racial/ethnic cohorts, it appears globally highest in Blacks, is intermediate in Caucasians and is lowest in Asians. The incidence and prevalence of venous thromboembolism is also strongly age-related, increasing nearly 90 fold from \ 15 to [ 80 years old. Definitive data on the relative fre- quency of venous thromboembolism across genders is lacking. Some studies report that gender is not an inde- pendent risk factor of venous thromboembolism, while others conclude that female gender might be a protective variable. The purpose of this review is to assess the rela- tionship between such demographic variables and venous thromboembolism. Keywords Thrombosis Á Venous thromboembolism Á Age Á Gender Á Ethnicity Introduction Venous thromboembolic (VTE) disease is a complex and multifaceted pathology, caused by the interaction of a plethora of genetic and environmental factors [1, 2]. Like cardiovascular disease (CVD) and other multifactorial pathologies, the many risk factors can be classified into those that are unmodifiable (for the presence of a genetic background) and those that are potentially avoidable or modifiable [2]. The most reliable approach to prevention, diagnosis, therapy and follow-up of thromboembolic dis- orders is that based on constructing a rational personalized medicine framework that can be applied in the clinical settings, and which would consider not only the type and circumstances of a thrombotic event, but also an evaluation of individual risk factors including those related to ethnic- ity, age and gender for assessing both the baseline risk of thrombosis and the potential therapeutic strategies [3]. It is without question that identification of patients at higher risk of VTE is advisable [4], in order to either modify the exposure to modifiable risk factors or to target primary and secondary prophylaxis [5]. In the inexorable progress towards individualization of risk and personalized medi- cine, several congenital and acquired risk factors have been already recognized, but less focus has been placed on the influence of certain demographic variables, especially eth- nicity, age and gender. An evaluation of these would help clinicians and healthcare professionals to develop preven- tion programs, and services specifically targeted toward risk burdens in each of these populations. Cognizant of this favorable outcome, the purpose of this review is to assess M. Montagnana Á G. C. Guidi Á G. Lippi (&) Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Universita ` di Verona, Ospedale Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134 Verona, Italy e-mail: giuseppe.lippi@univr.it; ulippi@tin.it E. J. Favaloro Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, Westmead, Australia M. Franchini Servizio di Immunoematologia e Trasfusione–Azienda Ospedaliero-Universitaria di Verona, Verona, Italy 123 J Thromb Thrombolysis (2010) 29:489–496 DOI 10.1007/s11239-009-0365-8