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Physical activity in the prevention and treatment of a thrombogenic profile in the obese: current evidence and research issues

RAURAMAA, RAINER; VÄISÄNEN, SARI B.

Medicine & Science in Sports & Exercise: November 1999 - Volume 31 - Issue 11 - p S631
Roundtable Consensus Statement

RAURAMAA, R. and S. B. VÄISÄNEN. Physical activity in the prevention and treatment of a thrombogenic profile in the obese: current evidence and research issues. Med. Sci. Sports Exerc., Vol. 31, No. 11, Suppl., pp. S631–S634, 1999.

Purpose: To evaluate the impact of regular physical activity on thrombogenic profile in obese individuals.

Design: Medline-based literature search with emphasis on controlled randomized clinical trials. The focus was on the impact of physical activity on platelet aggregation, fibrinogen, and plasminogen activator inhibitor-1 (PAI-1) in overweight and obese subjects.

Results: Physical activity increases acutely 1) platelet number and activity, 2) activation of coagulation leading to a thrombin generation, and 3) simultaneous activation of fibrinolysis. On the other hand, hemostatic changes resulting from regular exercise training are limited to few data on platelets and blood coagulation and to some indications of increased fibrinolysis. Obesity is a risk factor for atherosclerotic cardiovascular diseases, and it is associated with hypertriglyceridemia, hyperinsulinemia, and non-insulin-dependent diabetes (NIDDM). These states interfere with a balance between blood coagulation and fibrinolysis leading to an increased thrombogenesis. Regular physical activity reduces platelet aggregability, while the effects on plasma fibrinogen and fibrinolytic activity remain unclear.

Conclusions: Although obesity associates with several unfavorable derangements in the hemostatic system, data on the interactions of regular physical activity with blood coagulation in overweight or obese subjects are scarce. Therefore, controlled randomized clinical trials with adequate statistical power are needed for the evaluation of physical activity in the prevention and treatment of obesity-related atherothrombotic disorders.

Kuopio Research Institute of Exercise Medicine and Department of Physiology, University of Kuopio, FINLAND; and Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, FINLAND

Address for correspondence: Dr. Rainer Rauramaa, Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FIN-70100 Kuopio, Finland. E-mail: rainer.rauramaa@messi.uku.fi.

Roundtable held February 4–7, 1999, Indianapolis, IN.

© 1999 Lippincott Williams & Wilkins, Inc.