Physical Activity Reduces Risk for Anticoagulant-Associated Bleeding

Anticoagulant therapy is associated with major, even fatal, hemorrhage in elderly patients who fall or experience other trauma. Physical activity reduces the risk for falls in such patients, but whether it increases their risk for anticoagulant-related bleeding has been unclear.

To examine this issue, Swiss investigators conducted a prospective, multicenter cohort study of 988 patients (age, ≥65 years) who were receiving anticoagulant treatment for venous thromboembolism. Level of physical activity was assessed by patient questionnaire.

During a mean follow-up of 22 months (range, 11–33 months), the incidence rate of major bleeds was 6.9 per 100 patient-years. Incidence rates decreased with increasing physical activity: Bleed rates associated with low, moderate, and high activity levels were 11.6, 6.3, and 3.1 per 100 patient-years, respectively. After multivariable adjustment, patients with high activity levels had a significantly lower risk for bleeding than those with low activity levels (hazard ratio, 0.40; 95% confidence interval, 0.22–0.72). Patients with moderate activity levels had nonsignificantly lower risk for bleeding than those with low activity levels (HR, 0.72; 95% CI, 0.45–1.13).