Which of the following factors increases the risk for venous thromboembolism and stroke?

Which of the following factors increases the risk for venous thromboembolism and stroke?

• A. Non-smoking and younger age
• B. Cigarette smoking, age ≥35, and exogenous estrogen
• C. Regular exercise and healthy diet
• D. Age under 25 with no estrogen exposure

Answer: (B)

Raising the risk for venous thromboembolism and stroke occurs when factors promote clot formation and vascular injury, especially when they combine. Cigarette smoking damages the endothelium, increases platelet activation, and creates a prothrombotic state that can lead to both venous clots and arterial events like stroke. Being age 35 or older adds baseline thrombotic risk because vascular and coagulation changes accumulate with age. Exogenous estrogen, such as in combined hormonal therapies, increases hepatic production of clotting factors and reduces anticoagulant activity, tipping the balance toward thrombosis. When these factors occur together—smoking, older age, and estrogen exposure—the risk for both venous thromboembolism and stroke rises more than with any single factor alone. By contrast, not smoking and being younger lowers risk; regular exercise and a healthy diet improve vascular health and reduce thrombotic risk; and age under 25 with no estrogen exposure represents a low-risk scenario for these events.

Raising the risk for venous thromboembolism and stroke occurs when factors promote clot formation and vascular injury, especially when they combine. Cigarette smoking damages the endothelium, increases platelet activation, and creates a prothrombotic state that can lead to both venous clots and arterial events like stroke. Being age 35 or older adds baseline thrombotic risk because vascular and coagulation changes accumulate with age. Exogenous estrogen, such as in combined hormonal therapies, increases hepatic production of clotting factors and reduces anticoagulant activity, tipping the balance toward thrombosis. When these factors occur together—smoking, older age, and estrogen exposure—the risk for both venous thromboembolism and stroke rises more than with any single factor alone.

By contrast, not smoking and being younger lowers risk; regular exercise and a healthy diet improve vascular health and reduce thrombotic risk; and age under 25 with no estrogen exposure represents a low-risk scenario for these events.