Summary
A number of hemostatic changes involving platelets, coagulation and fibrinolysis have been reported after acute physical exercise. Results have sometimes been controversial, due to differences in subjects investigated, type of exercise and methods used for hemostatic evaluation. On the whole, physical exercise has been shown to induce: (1) increases in platelet number and activity, (2) activation of coagulation leading to a slight but significant thrombin generation and (3) activation of fibrinolysis. These changes are short lasting. Less known are hemostatic changes induced by exercise training programs: a few data are available on the effects on platelets and coagulation, whereas studies performed on fibrinolysis show a decrease in plasminogen activator inhibitor-1 levels at rest and an increase in fibrinolytic capacity after training.
References
Blackburn H, Jacobs DR. Physical activity and the risk of coronary heart disease. N Engl J Med 1988; 319: 1217.
Mehta P, Mehta J. Comparison of platelet function during exercise in normal subjects and coronary artery disease patients: potential role of platelet activation in myocardial ischemia. Am Heart J 1982; 103: 49.
Biggs R, MacFarlane RG, Pilling J. Observations on fibrinolysis. Experimental activity produced by exercise or adrenaline. Lancet 1947; II: 402.
Bennet PN. Effect of physical exercise on platelet adhesiveness. Scand J Haematol 1972; 9: 138.
Chen HI, Tang YR, Wu HJ, Jen CJ. Effects of acute exercise on bleeding time, bleeding amount and blood cell counts: a comparative study. Thromb Res 1989; 55: 503.
Dawson A, Ogston D. Exercise-induced thrombocytosis. Acta Haematol (Basel) 1969; 42: 241.
Finkel A, Cumming GR. Effect of exercise in the cold on blood clotting and platelets. J Appl Physiol 1965; 20: 423.
Ikkala E, Myllala G, Sarajas HS. Platelet adhesiveness and ADP-induced platelet aggregation in exercise. Ann Med Exp Fenn 1966; 44: 88.
Sarajas HSS, Konttinen A, Frick MH. Thrombocytosis evoked by exercise. Nature 1961; 192: 721.
Davis GL, Abildgaard CF, Bernauer EM, Britton M. Fibrinolytic and hemostatic changes during and after maximal exercise in males. J Appl Physiol 1976; 40: 287.
Dimitriadou D, Dessypris A, Louizou C, Mandalaki T. Marathon run: effects on platelet aggregation. Thromb Haemost 1977; 37: 451.
Dix CJ, Hassel DJ, Bruckdorfer KR. The increased sensitivity of platelets to prostacyclin in marathon runners. Thromb Haemost 1984; 51: 385.
Knudsen B, Brodthagen U, Gormsen J, Jordal R, Norregaard-Hansen K, Paulev PE. Platelet function and fibrinolytic activity following long distance running. Scand J Haematol 1982; 29: 245.
Mandalaki T, Dessypris A, Louizou C, Panayotopoulou C, Dimitriadou C. Marathon run III: effects on coagulation, fibrinolysis, platelet aggregation and serum cortisol levels. Thromb Haemost 1980; 43: 49.
Ohri VC, Chatterji JC, Das BK, Akthar M, Tewari SC, Bhattacharij P, Behl A. Effects of submaximal exercise on haematocrit, platelet count, platelet aggregation and blood fibrinogen levels. J Sport Med Phys Fitness 1983; 23: 127.
Rauramaa R, Salonen J, Seppanen K, Salonen R, Venalainen J, Ihanainen M, Rissanen V. Inhibition of platelet aggregability by moderate-intensity physical exercise: a randomized clinical trial in overweight men. Circulation 1986; 74: 939.
Sano T, Motomiya T, Yamazaki H, Shimamoto T. Enhancement of platelet sensitivity to ADP-aggregation by isometric exercise in arteriosclerotic patients and its prevention. Thromb Haemost 1977; 37: 329.
Small M, Tweddel AC, Rankin AC, Lowe GDO, Prentice CRM, Forbes CD. Blood coagulation and platelet function following maximal exercise: effect of beta-adrenoceptor blockade. Haemostasis 1984; 14: 262.
Stibbe J, Van Der Plas PM. Increase of plasma factor involved in ristocetin-induced platelet aggregation after exercise. Haemostasis 1974; 3: 137.
Warlow CP, Ogston D. Effect of exercise on platelet count, adhesion, and aggregation. Acta Haematol (Basel) 1974; 52: 47.
Craveri A, Christian M, Lanfredini M. Whole blood platelet aggregation after a submaximal physical effort. Int J Med 1990; 228: 46.
Piret A, Niset G, Depiesse E, Wyns W, Boeynams JM, Poortman J, Degre S. Increased platelet aggregability and prostacyclin biosynthesis induced by intense physical exercise. Thromb Res 1990; 57: 865.
Egeberg O. The effect of exercise on the blood clotting system. Scand J Clin Lab Invest 1963; 15: 8.
Poller L, Priest GM, Thomson JM. Platelet aggregation and strenuous exercise. J Physiol 1971; 213: 525.
Schernthaner G, Muhlhauser I, Bohm H, Seebacher C, Laimer H. Exercise induced in vivo platelet activation in patients with coronary artery disease and in healthy individuals. Haemostasis 1983; 13: 351.
Laustiola K, Seppala E, Nikkari T, Vapaatalo H. Exercise induced increase in plasma arachidonic acid and thromboxane B2 in healthy men: effect of β-adrenergic blockade. J Cardiovasc Pharmacol 1984; 6: 449.
Jakubowski JA, Thomson CB, Vallaincourt R, Valeri CR, Deykin D. Arachidonic acid metabolism by platelets of differing size. Br J Haematol 1983; 53: 503.
Hartman F. Changes in the clotting time of the blood of cats as a result of exercise. Am J Physiol 1927; 80: 716.
Mills CA, Necheles H. Variation in the coagulability of the blood normally and after food ingestion. Clin J Physiol 1928; 2: 19.
Schneider RA, Zangari VM. Variations in clotting time, relative viscosity, and other physicochemical properties of the blood accompanying physical and emotional stress in the normotensive and hypertensive subject. Psychosom Med 1951; 13: 289.
Rizza CR. Effect of exercise on the level of antihaemophilic globulin in human blood. J Physiol 1961; 156: 128.
De La Croix KA, Davis GL, Schneider DA, Lavoie P, Kintzing E, Waterfield DA. The effect of acute exercise and increased atmospheric pressure on the hemostatic mechanism and plasma cathecholamine levels. Thromb Res 1990; 57: 717.
Iatridis SG, Ferguson JH. Effect of physical exercise on blood clotting and fibrinolysis. J Appl Physiol 1963; 18: 337.
Ikkala E, Myllala G, Sarajas HS. Hemostatic changes associated with exercise. Nature 1963; 199: 459.
Neri Serneri GG, Gensini GF, Abbate R, Mugnaini C, Prisco D. The functional subunits of factor VIII in the assessment of hypercoagulability. In: Coccheri S, ed. Proceedings of the Fifth International Congress on Thromboembolism, Bologna, May 29–June 2, 1978. Pisa: Quaderni della Coagulazione; 1980: 146.
Korsan-Bengsten K, Conradson TB. Influence of two different beta-adrenergic blocking agents on the increase in fibrinolytic activity and factor VIII activity during submaximum exercise. Scand J Haematol 1974; 13: 377.
Bennet B, Ratnoff OD. Changes in antihemophilic factor (AHF), factor VIII procoagulant activity and AHF-like antigen in normal pregnancy and following exercise and pneumoen-cephalography. J Lab Clin Med 1972; 80: 256.
Denson KWE. The detection of factor VIII-like antigens in hemophilia carriers and in patients with raised levels of biologically active factor VIII. Br J Haematol 1973; 24: 451.
Prentice CRM, Forbes CD, Smith SM. Rise of factor VIII after exercise and adrenaline infusion, measured by immunological and biological techniques. Thromb Res 1972; 1: 493.
Stibbe J. Effect of exercise on f VIII-complex: proportional increase of ristocetin cofactor (von Willebrand factor) and f VIII-AGN, but disproportional increase of VIII-AHF. Thromb Res 1977; 10: 163.
Kopitsky RG, Switzer ME, Williams RS, et al. The basis for the increase in factor VIII procoagulant activity during exercise. Thromb Haemost 1983; 49: 53.
Prisco D, Paniccia R, Guarnaccia V, Olivo G, Taddei T, Boddi M, Gensini GF. Thrombin generation after physical exercise. Thromb Res 1993; 69: 159.
Ingram GC. Increase in antihaemophilic globulin activity following infusion of adrenaline. J Physiol 1961; 156: 217.
Cohen RJ, Epstein SE, Cohen LS, Dennis LH. Alteration of fibrinolysis and blood coagulation induced by exercise and the role of beta adrenergic-receptor stimulation. Lancet 1968; I: 1264.
El-Sayed MS. Fibrinolytic and hemostatic parameter response after resistance exercise. Med Sci Sports Exerc 1993; 25: 597.
Hansen JB, Wilsgard L, Olsen JO, Bjarne O. Formation and persistence of procoagulant and fibrinolytic activities in circulation after strenuous physical exercise. Thromb Haemost 1990; 64: 385.
Hawkey CM, Britton BJ, Wood WG, Peele M, Irving MH. Changes in blood catecholamine levels and blood coagulation and fibrinolytic activity in response to graded exercise in man. Br J Haematol 1975; 29: 377.
Collen D, Semeraro N, Tricot JP, Vermylen J. Turnover of fibrinogen, plasminogen, and prothrombin during exercise in man. J Appl Physiol 1977; 42: 865.
Small M, Simpson I, McGhie I, Douglas JT, Lowe GDO, Forbes CD. The effect of exercise on thrombin and plasmin generation in middle-aged men. Haemostasis 1987; 17: 371.
De Paz JA, Lasierra J, Villa JG, Vilades E, Martin-Nuno MA, Gonzalez-Gallego J. Changes in the fibrinolytic system associated with physical conditioning. Eur J Appl Physiol 1992; 65: 388.
Herren T, Peter B, Haeberli A, Straub PW. Increased thrombin-antithrombin III complexes after 1 h of physical exercise. J Appl Physiol 1992; 73: 2499.
Hansen JB, Olsen JO, Osterud B. Physical exercise enhances plasma levels of extrinsic pathway inhibitor (EPI). Thromb Haemost 1990; 64: 124.
Ferguson EW, Guest MM. Exercise, physical conditioning, blood coagulation and fibrinolysis. Thromb Diath Haemorrh 1974; 31: 63.
Hyers TM, Martin BJ, Pratt DS, Dreisin RB, Franks JJ, Enhanced thrombin and plasmin activity with exercise in man. J Appl Physiol 1980; 48: 821.
Marsh NA, Gaffney PJ. Some observations on the release of extrinsic and intrinsic plasminogen activators during exercise in man. Haemostasis 1980; 20: 238.
Vogt AV, Hofmann V, Straub PW. Lack of fibrin formation in exercise-induced activation of coagulation. Am J Physiol 1979; 236: H577.
Bartsch P, Haeberli A, Straub PW. Blood coagulation after long distance running: antithrombin III prevents fibrin formation. Thromb Haemost 1990; 63: 430.
Cash JD. Effect of moderate exercise on the fibrinolytic system in normal young men and women. BMJ 1966; 2: 502.
Sherry S, Fletcher AP, Alkjaersig N. Fibrinolysis and fibrinolytic activity in man. Physiol Rev 1959; 39: 343.
Cash JD, Woodfield DG, Allan AGE. Adrenergic mechanisms in the systemic plasminogen activator response to adrenaline in man. Br J Haematol 1970; 18: 487.
Cash JD, Allan AGE. The fibrinolytic response to moderate exercise and intravenous adrenaline in the same subjects. Br J Haematol 1967; 13: 376.
Winckelmann G, Meyer G, Roskamm H. Der Einfluß körperlicher Belastung auf Blutgerinnung und Fibrinolyse bei untrainierten Personen und Hochleistungssportlern. Klin Wochenschr 1968; 46: 712.
Rosing DR, Brakman P, Redwood DR, Goldesttein RE, Beiser GD, Astrup T, Epstein SE. Blood fibrinolytic activity in man. Diurnal variation and the response to varying intensities of exercise. Circ Res 1970; 27: 171.
Neri Serneri GG, Gensini GF, Abbate Gensini R. Open problems of fibrinolytic potential. In: Pratesi F, ed. Proceedings of the 9th Congress of International Union of Angiology, Florence, April 3–7, 1974; Turin: Edizioni Minerva Medica; 1974: 86.
Boddi M, Paniccia R, Bonechi F, Coppo M, Francalanci I, Bandinelli B, Fortini A, Prisco D. Acidosis is the major determinant of fibrinolysis activation induced by physical exercise. Thromb Res 1992; 65 [Suppl 1]: 595.
Chandler WL, Veith RC, Fellingham GW, Levy WC, Schwartz RS, Cerqueira MD, Kahn SE, Larson VG, Cain KC, Beard JC, Abrass IB, Stratton JR. Fibrinolytic response during exercise and epinephrine infusion in the same subjects. J Am Coll Cardiol 1992; 19: 1412.
Speiser W, Langer W, Pschaiick A, Selmayr E, Ibe B, Nowacki PE, Muller-Berghaus G. Increased blood fibrinolytic activity after physical exercise: comparative study in individuals with different sporting activities and in patients after myocardial infarction taking part in a rehabilitation sports program. Thromb Res 1988; 51: 543.
Van den Burg PJM, Dooijewaard G, Vliet M van, Mosterd WL, Kluft C, Huisveld IA. Differences in u-PA and t-PA increase during acute exercise: relation with exercise parameters. Thromb Haemost 1994; 71: 236.
Dooijewaard G, Boer A de, Turion PN, Cohen AF, Breimer DD, Kluft C. Physical exercise induces enhancement of urokinase-type plasminogen activator (u-PA) levels in plasma. Thromb Haemost 1990; 65: 82.
Das PC, Allan AGE, Woodfield DG, Cash JD. Fibrin degradation products in sera of normal subjects. BMJ 1967; 4: 718.
Ferguson EW, Barr CF, Bernier LL. Fibrinogenolysis and fibrinolysis with strenuous exercise. J Appl Physiol 1979; 47: 1157.
Ferguson EW, Bernier LL, Shaughness GP, Boucher JH. Fibrinolytic activity without fibrinogenolysis during long-distances racing in horses. J Appl Physiol 1981; 50: 245.
Karp JE, Bell WR. Fibrinogen-fibrin degradation products and fibrinolysis following exercise in humans. Am J Physiol 1974; 227: 1212.
Arai M, Yorifuji H, Ikematsu S. Influences of strenuous exercise (triathlon) on blood coagulation and fibrinolytic system. Thromb Res 1990; 57: 465.
Drygas WK. Changes in blood platelet function, coagulation, and fibrinolytic activity in response to moderate, exhaustive and prolonged exercise. Int J Sports Med 1988; 9: 67.
Dufaux B, Order U, Hollmann W. Can physical exercise induce an effective fibrinolysis? Thromb Res 1984; 36: 37.
Rauramaa R, Salonen JT, Kukkonen-Harjula K, Seppanen K, Seppala E, Vapaatalo H, Huttunen JK. Effects of mild physical exercise on serum lipoproteins and metabolites of arachidonic acid: a controlled randomized trial in middle-aged men. BMJ 1984; 288: 603.
Wennmalm A, Benthin G, Caidahl K, Granstrom EF, Lanne B, Persson L, Petersson AS, Winell S. Non-invasive assessment of the cardiovascular eicosanoids, thromboxane A2, and prostacyclin, in randomly sampled males, with special reference to the influence of inheritance and environmental factors. Clin Sci 1990; 79: 639.
Connelly JB, Cooper JA, Meade TW. Strenuous exercise, plasma fibrinogen, and factor VII activity. Br Heart J 1992; 67: 351.
Williams RS, Logue EE, Lewis JL, Barton T, Stead N, Wallace AG, Pizzo SV, Physical conditioning augments the fibrinolytic response to venous occlusion in healthy adults. N Engl J Med 1980; 302: 987.
Ferguson EW, Bernier LL, Banta GR, Yu-Yahiro J, Schoomaker EB. Effects of exercise on conditioning on clotting and fibrinolytic activity in men. J Appl Physiol 1987; 62: 1416.
Menon IS, Burke F, Dewar HA. Effect of strenuous and graded exercise on fibrinolytic activity. Lancet 1968; I: 700.
Stratton JR, Chandler WL, Schwarzt RS, Cerqueira MD, Levy WC, Kahn SE, Larson VG, Cain KC, Beard JC, Abras IB. Effects of physical conditioning on fibrinolytic variables and fibrinogen in young and old healthy adults. Circulation 1991; 83: 1692.
De Geus EGC, Kluft C, De Bart ACW, Doornen LJP van. Effects of exercise training on plasminogen activator inhibitor activity. Med Sci Sports Exerc 1992; 24: 1210.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Prisco, D., Francalanci, I., Filippini, M. et al. Physical exercise and hemostasis. Int J Clin Lab Res 24, 125–131 (1994). https://doi.org/10.1007/BF02592441
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02592441