Thrombosis is a multifactorial pathology. In addition to the environmental factors, there are genetic components which either predispose or protect against its occurrence. Some are common to only a small number of subjects: these are the high risk families to thrombotic disease. Others are present in a larger percentage of the general population: this is called polymorphism and its clinical expression is usually modest. The role of these genetic factors in the development of thrombosis is not easy to demonstrate, especially as there are many gene-gene and gene-environment interactions. Nevertheless, the genetic basis of venous thrombosis is well established and the value of this knowledge in the management of these patients is becoming recognised. On the other hand, there are many genetic factors in arterial pathology and the role of each taken in isolation is small. Well-targeted large scale trials are required to determine their effects.
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