Physical Activity Status and Adverse Age-Related Differences in Coagulation and Fibrinolytic Factors in Women

Abstract

Abstract-Adverse changes in coagulation and fibrinolytic factors are thought to contribute to the increased risk of cardiovascular disease and atherothrombosis with age. We tested the hypothesis that such age-related changes in specific coagulation and fibrinolytic factors are absent in physically active women. Resting levels of plasma fibrinogen, tissue-type plasminogen activator (t-PA) antigen and activity, plasminogen activator inhibitor-1 (PAI-1) antigen and activity, and fibrin D-dimer were measured in 24 healthy premenopausal women: 11 sedentary (aged 28Ϯ1 years; Pre-S) and 13 physically active (aged 30Ϯ1 years; Pre-PA) and in 27 healthy postmenopausal women: 14 sedentary (aged 61Ϯ1 years; Post-S) and 13 physically active (aged 58Ϯ1 years; Post-PA). Post-S had higher (PϽ.05) fibrinogen, t-PA antigen, PAI-1 antigen, PAI-1 activity, and fibrin D-dimer levels and lower t-PA activity than Pre-S. Post-PA demonstrated lower (PϽ.01) plasma fibrinogen, t-PA antigen, PAI-1 antigen, and PAI-1 activity and higher (PϽ.01) t-PA activity levels than Post-S. In addition, plasma fibrin D-dimer levels tended (Pϭ.06) to be lower in Post-PA than in Post-S. Although plasma levels of fibrinogen and fibrin D-dimer in Post-PA were lower than in Post-S, they were higher (PϽ.05) than in Pre-PA. Importantly, however, the fibrinolytic profile of Post-PA did not differ from that of Pre-PA. The results of the present study demonstrate that the adverse age-associated differences in plasma fibrinogen concentrations and the endogenous fibrinolytic system in sedentary healthy women are either attenuated or absent in highly physically active women. The smaller or absent age-related differences in coagulation and fibrinolytic factors in women who habitually exercise may represent an important mechanism contributing to their lower age-related increase in both cardiovascular disease and atherothrombotic events. Future studies need to determine whether women who are moderately active would demonstrate the same favorable hemostatic profile. (Arterioscler Thromb Vasc Biol. 1998;18:362-368.)Key Words: aging Ⅲ exercise Ⅲ fibrinogen Ⅲ fibrinolytic system Ⅲ fibrin D-dimer A dvancing age is associated with an increased risk of CVD in general and atherosclerotic vascular disease in particular. 1 In women, the incidence of both CVD and thrombosis increases after the onset of menopause. 2,3 It has been suggested that age-related changes in coagulation and fibrinolytic factors contribute to the increased risk of atherothrombotic events in postmenopausal women by accelerating the atherosclerotic process and promoting thrombus formation. 4 -6 Indeed, higher plasma concentrations of fibrinogen 4 and fibrin D-dimer, 7 both markers of thrombogenic risk, and reduced endogenous fibrinolytic activity 5 have been reported in healthy postmenopausal compared with premenopausal women.In contrast to aging, regular physical activity is associated with favorable coagulation and fibrinolytic function. 8 -10 We have previously shown that physically active postmenopausal...

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