Life after deep vein thrombosis (DVT) or pulmonary embolism (PE) can be stressful. Recovery can take upwards of several months and you’ll need to make sure you adhere to your doctor’s medication and treatment schedule.
After the initial recovery you’ll also need to take precautions to prevent future blood clots. This is especially important because a history of DVT may increase your risk of another blood clot, per Cleveland Clinic.
Individual risk will depend on the cause of the blood clot, says Scott Cameron, MD, a specialist in blood vessel disorders and platelet dysfunction at Cleveland Clinic.
For example, DVT patients who have a genetic mutation that puts them at higher risk of blood clots have a very high risk of recurrent DVT and will need to be on blood thinners for life, Dr. Cameron says. But for patients whose DVT is the result of a temporary risk factor, such as surgery or trauma, the risk of future blood clots is quite low.
Sometimes, the cause of a DVT is unknown. “For those patients, if they’ve been treated with a blood thinner for three to six months, the risk of having a recurrent blood clot in the next year is actually about 10 to 15 percent,” Cameron says. “And within five years, the risk of having a recurrent blood clot is 50 percent.”
After a blood clot, it’s important to follow your doctor’s advice and treatment plan. Generally, these six lifestyle tips will not only keep you healthy, but can help prevent future blood clots.
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1. Stay as Active as Possible
One of the risk factors for DVT is inactivity, including sitting for extended periods of time, such as on a long-haul flight or being immobile after a serious injury or surgery.
“Staying active with activities like walking, biking, and swimming can help to increase blood flow in the veins of the legs,” says Geoffrey Barnes, MD, assistant professor of internal medicine and a vascular cardiologist at the Michigan Medicine Frankel Cardiovascular Center in Ann Arbor.
“This will help to prevent future blood clots from forming.”
If you’re new to exercise, don’t be intimidated. When it comes to preventing blood clots, everyone can reap the benefits of physical activity. A research review published in the European Journal of Epidemiology in November 2019 concluded that regular exercise is significantly associated with lower risk of venous thromboembolism (VTE), a condition that includes DVT and PE, regardless of body mass index (BMI).
How much physical activity you should aim for will depend on several factors, including your age, other health conditions you have, and how long it’s been since your DVT.
Generally, during the initial recovery, Cameron recommends his patients move as much as possible. This may be as simple as getting in and out of bed and walking around.
“I tell my patients to mobilize yourself as much as you can,” he says. “Certainly, if you’re in severe pain, your body is going to tell you when it’s too much. Obviously try not to inflict pain, but you should be moving enough that you’re getting at least 1,000 to 2,000 steps per day. That will assist the recovery process.”
After you’ve recovered, talk to your doctor about an appropriate exercise plan. For optimal heart health, the American Heart Association (AHA) recommends getting at least 150 minutes per week of moderate-intensity physical activity, such as brisk walking, gardening, or cycling.
2. Maintain a Healthy Weight
Obesity is a risk factor for DVT. According to one study of 265 participants, being overweight (having a BMI over 25) was associated with a threefold increased risk of VTE, and obesity (having a BMI over 30) was linked to a fivefold risk.
“People who are overweight or obese are at high risk of developing a blood clot because the extra weight they carry makes it harder for blood in the legs to return to their heart and lungs,” Dr. Barnes says.
Joel Garcia, MD, an interventional cardiologist at the Orlando Health Heart and Vascular Institute in Florida, notes that obesity raises risk factors that can affect blood coagulation, including insulin resistance and chronic inflammation. These can increase platelet activity, which increases the risk of blood clots, he says.
“It is also worth discussing that obesity sets the stage of further lack of activity and worsening venous insufficiency which may promote blood stasis in the legs and ultimately clots,” Dr. Garcia says. Blood stasis means that the blood is not flowing optimally through the body.
If you are overweight or obese, talk to your doctor or a dietitian about a healthy weight loss plan. The AHA advises focusing on a wide variety of fruits, vegetables, and whole grains in your diet, as well as healthy sources of protein like legumes, nuts, fish, and low-fat and nonfat dairy. Also limit processed foods and added sugars.
3. If You Smoke, Consider Quitting
Smoking cigarettes is a major risk factor for DVT. “Research (PDF) has shown us that tobacco smoke increases inflammation in the blood vessels, causes cholesterol build up to occur, and damages the heart and lungs,” Barnes says.
Smoking also impacts the number and quality of blood platelets, or the cells that stop bleeding by sticking together to form a clot.
According to one study, smoking increases activation of platelets by up to 100 times.
“When you have an abnormally high number of blood platelets, you have a high risk of developing blood clots, heart attack, and stroke,” Garcia says.
If you need help quitting, talk to your doctor about strategies that can make it easier to stop smoking.
4. Plan Ahead for Long-Haul Flights
Long-distance travel can increase the risk of blood clots, according to the Centers for Disease Control and Prevention (CDC).
Some research suggests the prevalence of DVT within 48 hours of flying on an airplane is between 2 and 10 percent.
However, Cameron notes that the risk only applies to long-haul travelers.
“A flight that's less than seven or eight hours really is not a risk factor for DVT,” he says.
Part of the reason for the increased risk on long-haul flights is immobilization due to being in a tight space on the airplane. Lower oxygen levels also play a role.
"At high altitude such as what would be experienced with air travel, oxygen tension is lower,” Cameron says. “When oxygen tension is lower, established scientific data shows platelets (the cells that form blood clots) are more readily activated. This increases the risk for DVT."
To reduce the risk of DVT on long-haul trans-Atlantic or trans-Pacific flights, he recommends wearing compression stockings while on the plane and getting up to walk around every hour.
“When I fly, I always choose an aisle seat because it’s easier to get up and move around,” Cameron says. “If you know you’ll be taking a long flight that’s 12 hours or more, it’s important to think ahead and book early, that way you can be guaranteed an aisle seat.”
5. Stay Hydrated
Dehydration contributes to the development of sluggish blood flow, which may lead to blood clots, NYU Langone notes.
“Dehydration tends to worsen the formation of clots because of the inability of that blood flow to move efficiently through those veins,” Garcia says.
Staying hydrated is especially important when you’re immobile for long periods of time (such as on long-haul flights) to promote movement of blood in the lower extremities, he notes.
Garcia recommends drinking 8 to 10 glasses of water a day for optimal blood flow.
6. Manage Stress
Managing stress is an important part of maintaining good heart health, including preventing a DVT.
“Stress can increase blood pressure and inflammation in the body,” Barnes says. “Both of these contribute to the risk of blood clots, heart attacks, and stroke.”
Stress management techniques can look different for everybody. The AHA recommends practicing gratitude, spending time outdoors, and deep breathing to help cope with stress.
You may also want to give mindfulness meditation a try. One study of more than 61,000 people published in June 2020 in the American Journal of Cardiology found that people who meditated had lower rates of high cholesterol, high blood pressure, diabetes, stroke, and coronary artery disease, compared with participants who did not meditate. All of these factors can help decrease the risk of blood clots, Garcia notes.