Endurance training modifies exercise-induced activation of blood coagulation: RCT

Abstract

Randomized controlled trials (RCTs) on the topic of physical training and blood coagulation are rare and the effects are unclear. The aim of this study was to investigate whether endurance training adjusts blood coagulation and fibrinolysis at rest and after exercise. The study included 50 healthy untrained non-smokers randomized into training (TR 49 ± 6 years) or control group (CO 48 ± 6 years). Each subject performed an exercise test adjusted at 80 % individual anaerobic threshold (IAT) for 60 min before and after 12 weeks (80 % IAT: before TR 123 ± 20, CO 125 ± 26 W; after TR 148 ± 23 W, CO 127 ± 25 W; mean ± SD). Blood was taken at rest and after exercise to determine coagulation (e.g., aPTT, thrombin potential, TAT, F1+2, several coagulation factors) and fibrinolytic (e.g., tPA, PAI) parameters. The training intervention induced an elevation of physical capacity in TR by 17 % (rel. VO2max) that led to a statistical relevant prolongation of aPTT at rest. Although absolute power output during the second exercise test was 20 % higher in TR, we detected an attenuated exercise-induced decrease of aPTT and attenuated increase of F1+2 after training. Resting levels of tPA- and PAI-Ag decreased slightly but not significantly after training. Exercise-induced changes were comparable after training in spite of higher power output in TR. Although the effects are small in healthy men, training modifies exercise-induced blood coagulation positively. The fact that exercise-induced changes in blood coagulation and fibrinolysis are rather attenuated or unchanged in the training group, in spite of a 20 % higher absolute power output during exercise, substantiates the adjusting effect of endurance training and the importance of physical fitness in primary prevention.

Effects of 6 Months of Active Commuting and Leisure-Time Exercise on Fibrin Turnover in Sedentary Individuals with Overweight and Obesity: A Randomised Controlled Trial

“…This was not confirmed in the present study, where no effects on ETP were observed after 3 and 6 months of active commuting or moderate- or vigorous-intensity leisure-time exercise 4-5 times/week. To our knowledge, only Hilberg et al have previously investigated the effects of physical training on fasting levels of ETP in healthy adults, and similar to the present study, they reported no effects of 12 weeks of vigorous-intensity exercise on men who are overweight and who exercised with a frequency of 3-4 times/week [24]. …”

“…Acute exercise is known to activate coagulation and fibrinolytic properties [22, 24, 45–47], and the findings of the present study, along with the findings by Hilberg et al [24], may suggest that less-frequent activation of coagulation through ∼4 exercise sessions/week for 3 or 6 months does not lower ETP levels in overweight individuals. We speculate that high-frequency (daily) acute exercise with coagulation activation might consume coagulation factors and thereby reduce ETP.…”

“…Hilberg et al [24] also demonstrated unchanged levels of F1 + 2 following 12 weeks of vigorous-intensity exercise in men (40–60 y), whereas Lockard et al [39] showed a decrease in F1 + 2 following 6 months of vigorous-intensity aerobic exercise (3 sessions/week) in combination with the American Heart Association diet in men and postmenopausal women (50–75 y). The deviating findings may be ascribed to the age difference between the populations and the differences in dietary habits.…”

“…The plasma fibrinolytic activity is primarily determined by the active forms of tissue plasminogen activator (t-PA) and its inhibitor plasminogen activator inhibitor type 1 (PAI-1), and no previous studies have assessed the global fibrinolytic activity in relation to long-term exercise. Only a few studies have measured t-PA activity and PAI-1 activity with either no changes observed after 12 weeks of vigorous-intensity exercise in moderately overweight men [24] or favorable effects on t-PA activity (increase) and PAI activity (reduction) after long-term (6–12 months) vigorous-intensity exercise 3–5 days/week in older, but not younger, men [43] and in men with peripheral arterial disease [44]. Also, the protein concentration of PAI-1 (PAI : Ag) affects the global fibrinolytic activity, and we have recently demonstrated that active commuting and leisure-time exercise have no effects on PAI : Ag in the present study [26], thus supporting the results for global fibrinolytic activity.…”

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“…The beneficial effect of aerobic exercise in accelerating the metabolic rate and burn fat, fight obesity and increase blood circulation leading to transfer larger amount of oxygen and nutrients to the muscles has already be proven by research (Hilberg et al, 2013;Mikus et al, 2011;Sand et al, 2013). The increase in aerobic physical activity is now considered a key component of lifestyle modification in order to prevent and treat high blood pressure (Whelton et al, 2002).…”