CDC Division of Blood Disorders: public health research activities in venous thromboembolism.

Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), and is an important and growing public health issue. The precise number of people affected by VTE is unknown. However, based on prospective studies, VTE is estimated to affect 300 000 to 600 000 (1 to 2 per 1000) people in the United States annually.1–3 Not only is the high prevalence of VTE associated with substantial morbidity (one-third of people with DVT will have complications associated with postthrombotic syndrome), but it is also the cause of substantial mortality with 30% of persons with VTE dying within 1 month of diagnosis and about 25% of those with PE presenting with sudden death.4 In addition, many affected (about 30%) will experience recurrence of DVT/PE within 10 years of an initial DVT/PE.5 Fortunately, much of the morbidity and mortality associated with VTE is preventable with early and accurate diagnosis and management. However, one of the major challenges for preventing VTE is the ability to effectively predict which individuals are at greatest risk and ensure access to appropriate care. VTE is a multifactorial disease involving both genetic and acquired risks in all age groups; however, the interplay of these risk factors on disease expression is not fully understood. Many of the acquired risks such as obesity, advanced age, air travel, and chronic diseases are increasing in the US population, suggesting that we can expect to see increasing numbers of people affected by VTE. Awareness of VTE is crucial; because many healthcare providers and individuals at risk are unaware of the signs and symptoms of VTE, opportunities for providing primary prevention and preventive prophylaxis are often missed. The Division of Blood Disorders (DBD) located in the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/ncbddd/hbd/default.htm includes in its mission the prevention of VTE and its complications. The division has 3 teams, the Epidemiology and Surveillance, Laboratory Research (molecular and clinical hemostasis), and Prevention Research, that work closely together to meet the division’s goals through research of VTE determinants, complications, and outcomes while also promoting education and outreach needed to raise awareness of VTE among the general public and healthcare providers. Activities in which the CDC is engaged for the prevention of VTE include the following: