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Risk Factors for Developing a Blood Clot

What causes hypercoagulable states?

A hypercoagulable state is the medical term for a condition in which there is an abnormally increased tendency toward blood clotting (coagulation).


Hypercoagulable states are usually genetic (inherited) or acquired conditions. The genetic form of this disorder means a person is born with the tendency to form blood clots. Acquired conditions are usually a result of surgery, trauma, medications or a medical condition that increases the risk of hypercoagulable states.


Inherited hypercoagulable conditions include:

  • Factor V Leiden (the most common)
  • Prothrombin gene mutation
  • Deficiencies of natural proteins that prevent clotting (such as antithrombin, protein C and protein S)
  • Elevated levels of homocysteine
  • Elevated levels of fibrinogen or dysfunctional fibrinogen (dysfibrinogenemia)
  • Elevated levels of factor VIII (still being investigated as an inherited condition) and other factors including factor IX and XI
  • Abnormal fibrinolytic system, including hypoplasminogenemia, dysplasminogenemia and elevation in levels of plasminogen activator inhibitor (PAI-1 )

Acquired hypercoagulable conditions include:

  • Cancer
  • Some medications used to treat cancer, such as tamoxifen, bevacizumab, thalidomide and lenalidomide
  • Recent trauma or surgery
  • Central venous catheter placement
  • Obesity
  • Pregnancy
  • Supplemental estrogen use, including oral contraceptive pills (birth control pills)
  • Hormone replacement therapy
  • Prolonged bed rest or immobility
  • Heart attack, congestive heart failure, stroke and other illnesses that leads to decreased activity
  • Heparin-induced thrombocytopenia (decreased platelets in the blood due to heparin or low molecular weight heparin preparations)
  • Lengthy airplane travel, also known as “economy class syndrome”
  • Antiphospholipid antibody syndrome
  • Previous history of deep vein thrombosis or pulmonary embolism
  • Myeloproliferative disorders such as polycythemia vera or essential thrombocytosis
  • Paroxysmal nocturnal hemoglobinuria
  • Inflammatory bowel syndrome
  • Nephrotic syndrome (too much protein in the urine)

To research this topic in more detail, be sure and check out the “Factor V Leiden Research and Resource Library”.

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