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Relationship of physical fitness, hormone replacement therapy, and hemostatic risk factors in postmenopausal women

¹Department of OBGYN, Johns Hopkins Medical Center, Baltimore, Maryland ²Hematology Research Laboratory, Division of Hematology/Oncology, Georgetown University Medical Center, Washington, District of Columbia; and ³Kinesiology Department, College of Applied Life Studies, University of Illinois at Urbana-Champaign, Champaign, Illinois

Submitted 18 June 2004 ; accepted in final form 6 December 2004

This cross-sectional study evaluated the relationship of physical fitness, hormone replacement therapy (HRT), and hemostatic profiles at rest and after an acute bout of maximal exercise in 48 healthy postmenopausal women. Subjects were categorized by fitness and HRT user status into four groups: unfit nonusers, fit nonusers, unfit users, and fit users. Fibrinolytic variables tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) activity, and antigen and prothrombin fragment 1 + 2, a molecular marker of in vivo thrombin generation, were measured before and after maximal exercise. Fibrinogen was also measured at rest. Higher tPA and lower PAI-1 activities (P < 0.05) were seen in HRT users and fit groups. tPA and PAI-1 antigens were lower in HRT and fit groups (P < 0.05) but not after correction for body mass index. Prothrombin fragment 1 + 2 was lower in the fit groups regardless of HRT status (P < 0.05). Fibrinogen was similar in all groups. Favorable hemostatic profiles were observed in physically fit compared with unfit women, especially in HRT nonusers. Thus fitness is more strongly related to these hemostatic risk factors compared with HRT since HRT did not affect these hemostatic variables in fit postmenopausal women.

fibrinolysis; coagulation; menopause; exercise; cardiovascular disease