Holiday travel can bring joy and connection, as well as hassles and stress. You may be particularly worried about traveling if you’re at a higher risk for venous thromboembolism (VTE), or blood clots that form in your veins.
Sitting for extended periods of time increases the risk for VTE, which can take the form of deep vein thrombosis (DVT), a clot that typically forms in the deep veins of the legs, potentially causing painful symptoms in the area. A clot may also travel to your lungs and restrict or cut off blood flow, known as pulmonary embolism (PE) — a potentially life-threatening emergency.
While it’s important to take the risk for blood clots seriously if you have underlying risk factors, most people can travel without any undue risk for VTE, according to David Garcia, MD, a professor of hematology at the University of Washington School of Medicine in Seattle. “The absolute risk of a blood clot due to air travel is going to be small for just about everyone,” he says, noting that air travel appears to carry a higher risk for VTE than other forms of transportation.
The overall risk for symptomatic DVT linked to air travel appears to be less than 1 percent, Dr. Garcia says, based on reviews of many studies on the subject. But one analysis found that the overall incidence of DVT from long-haul flights — whether or not there were symptoms — may be as high as 3 to 12 percent.
You may be at a higher risk for VTE if any of the following situations or conditions apply to you, according to the Centers for Disease Control and Prevention (CDC):
- Personal or family history of blood clots
- Recent hospitalization, surgery, or injury
- Current or recent pregnancy
- Taking oral birth control pills or estrogen-based hormone replacement therapy
- Cancer or undergoing chemotherapy
- Congestive heart failure
- Inflammatory bowel disease
- Older age
While there’s no way to absolutely avoid blood clots while traveling, some simple steps may reduce your risk for VTE during and immediately after travel — and maybe just as importantly, give you peace of mind. Here’s what you can do to take worrying about blood clots off your itinerary.
1. Stay Hydrated
When you’re dehydrated, your blood vessels narrow and your blood thickens, increasing your risk for blood clots, according to the American Heart Association. Staying hydrated can be a particular challenge when traveling, since you may not have easy access to water or other beverages at all times. That’s why it’s important to plan ahead — such as by filling up an empty water bottle once you get through security at the airport or stocking bottled water for a long car trip.
It’s also important to avoid beverages that can lead to dehydration when you travel. That means not drinking more than a small amount of alcohol, according to Garcia, and also not drinking large amounts of soda.
2. Break Up Your Travel
Since sitting for longer periods increases the risk for VTE, it stands to reason that shorter trips pose less of a risk, Garcia says. This is particularly true when it comes to air travel — the only form of travel that has been definitely linked to a higher risk for blood clots, according to Garcia.
“People who travel on flights of more than four to five hours have a slight increase in the risk of blood clots,” says Garcia. “Fortunately, the dangers they pose are usually not going to result in catastrophe within the span of two to six hours.”
If you experience symptoms of a blood clot while traveling, it’s important to seek medical care as soon as possible — another reason why shorter trips may be appealing to some people. “Don’t check into your hotel,” says Garcia, if you experience possible symptoms of VTE. “Don’t delay. Go get care right away after landing.”
3. Get Up and Move
Just because you’re on a plane — or train, bus, or boat — for an extended period doesn’t mean you need to stay glued to your seat. When possible, the CDC recommends standing up and, if space permits, walking around occasionally, ideally at least every two to three hours. If you’re traveling by car, plan to take breaks for stretching and walking around.
Garcia says that other forms of transportation may not pose the same level of risk for VTE as air travel because some of the risk linked to air travel could be due to lower oxygen levels in airplane cabins. Still, the potential benefits of movement apply to any form of travel that involves extended sitting.
4. Do Leg Exercises in Your Seat
If you can’t get up and move for some reason — or if you want even more movement — you can move your legs around while you’re in your seat. The CDC suggests the following seated exercises to reduce your blood clot risk:
- Raise and lower your heels, keeping your toes on the floor.
- Raise and lower your toes, keeping your heels on the floor.
- Tighten and release your leg muscles (certain areas or your whole leg).
Stretching out your legs in front of you is also a good idea, Garcia says, but this may not be possible in many travel situations.
5. Wear Compression Stockings
Properly fitted compression stockings are likely to reduce the risk for blood clots while traveling, says Garcia — in fact, this was the conclusion of a research review for which he provided commentary. Garcia compares compression stockings to the life vest found underneath your seat on a plane — unlikely to make a difference on any given flight but providing reassurance to many people.
6. Take Medications as Prescribed
It goes without saying that when you travel, you shouldn’t let it disrupt taking any regular medications — especially anticoagulants (blood thinners), taken to reduce your risk for blood clots, or less powerful clot-preventing antiplatelet drugs like aspirin. But for people who aren’t taking aspirin regularly on their doctor’s advice, taking it when you travel to prevent clots is not recommended, according to the CDC.
If you take a blood thinner, you should feel safe traveling, says Garcia. “Something I get asked a lot is: Do I still have to be concerned about blood clots if I’m taking a blood thinner? And the answer is absolutely not,” he says. “Whatever risk air travel might add is going to be washed out completely by the drug’s effects.” That doesn’t mean your risk for blood clots is zero, but it does mean you shouldn’t be unduly worried about this risk, especially if you take other precautions to prevent blood clots when you travel.