Race, ABO blood group, and venous thromboembolism risk: Not black and white

BACKGROUND: The rate of venous thromboembolism (VTE) has been reported to be higher in blacks compared to whites. Non-O blood groups have also been associated with a significantly higher VTE risk. Given that a higher proportion of blacks have O blood group, one might have expected that black individuals would have fewer VTEs. STUDY DESIGN AND METHODS: In this study, we analyzed race, sex, age, ABO or Rh blood group, and VTE risk in 60,982 black and white patients admitted over a span of 10 years. RESULTS: The overall occurrence of VTEs was 7.6%, higher in males (8.7% males vs. 7.2% females), higher in non-O blood groups (8.5% non-O vs. 6.9% O blood group), and increased with age (5.8% <65 years, 11.3% ≥65 years). No difference in VTE rate was noted with Rh antigen positivity. When stratified by age, VTE rate was consistently higher in blacks and non-O blood groups. No difference was detected among the various non-O blood groups. To assess the potential confounder of comorbidities, we stratified patients according to Charlson comorbidity score. In a subgroup of healthy patients with age-independent Charlson comorbidity scores of 0 (n = 28,387), blacks still had an increased VTE risk and this risk was still higher with increasing age and in those with non-O blood groups. CONCLUSION: We conclude that black race and non-O blood groups have increased VTE risk when stratified for age and that associated comorbidities do not explain these differences.