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Biomedical subjects

Bo Fernhall

Publications and source records attributed to Bo Fernhall.

At least 19 recordsLinked to original sources

Slow heart rate recovery after exercise is associated with carotid atherosclerosis.

OBJECTIVE: Slow heart rate recovery (HRR) after exercise is an estimate of impaired parasympathetic tone and predictor of all-cause and cardiovascular mortality. Carotid atherosclerosis is associated with high risk of developing coronary heart disease (CHD) and stroke. We tested the hypothesis that slow HRR is associated with carotid atherosclerosis in a cross-sectional study of 12,712 middle-aged men (age 49.1+/-8.9 years). METHODS: Carotid atherosclerosis was measured using B-mode ultrasonography and defined as stenosis >25% and/or intima-media thickness >1.2mm. HRR was calculated as the difference between peak heart rate during a graded exercise treadmill test and heart rate 2 min after cessation of exercise. RESULTS: The prevalence of carotid atherosclerosis was 8.4%. The prevalence of atherosclerosis was significantly higher among subjects in the lowest (<44 bpm) versus the highest (>61 bpm) quartile of HRR (14.4% versus 4.1%, p<0.001). In multivariable logistic regression models adjusted for established CHD risk factors, inflammatory markers, and exercise capacity, subjects in the lowest quartile of HRR (<44 bpm) were 1.50 times (95% CI: 1.13-2.00) more likely to have carotid atherosclerosis than subjects in the highest quartile (HRR>61 bpm). CONCLUSIONS: Slow heart rate recovery after exercise, an index of decreased parasympathetic activity, is associated with carotid atherosclerosis independent of established risk factors in middle-age men.

Adult↗

Effect of single-leg resistance exercise on regional arterial stiffness.

To examine the effects of lower-limb unilateral resistance exercise on central and peripheral arterial stiffness, thirteen participants (7 male and 6 female, mean age = 21.5 +/- 0.7 years) performed leg press exercise using their dominant leg. Pulse wave velocity (PWV) was used to measure central (carotid to femoral) and peripheral (femoral to dorsalis pedis of both legs) arterial stiffness before, 5 min post, and 25 min post exercise. No change was found in central PWV. A leg-by-time interaction was found as peripheral PWV in the non-exercised leg did not change (7.9 +/- 0.3 m/s to 7.9 +/- 0.3 m/s to 8.0 +/- 0.3 m/s, P = 0.907) while peripheral PWV in the exercised leg significantly decreased from pre (8.7 +/- 0.4 m/s) to 5 min post exercise (7.5 +/- 0.3 m/s, P = 0.008) and 25 min post exercise (7.8 +/- 0.3 m/s, P = 0.031). Systolic blood pressure (BP) increased significantly from pre (126.9 +/- 3.4 mmHg) to 5 min post exercise (133.7 +/- 4.3 mmHg, P = 0.023) and was not different than resting values 25 min post exercise (123.2 +/- 3.1 mmHg). There was no change in diastolic BP. Compared to heart rate (HR) pre-exercise (55.4 +/- 1.4 bpm), HR was significantly increased 5 min post exercise (70.7 +/- 3.0 bpm, P = 0.001) and 25 min post exercise (69.1 +/- 2.0, P = 0.001). Acute resistance exercise appears to decrease arterial stiffness in the exercised leg while having no effect on central arterial stiffness or arterial stiffness of the non-exercised leg. These findings suggest that regional changes rather than systemic alterations may influence arterial stiffness following acute resistance exercise.

Adult↗

Cardiovascular responses to static exercise in boys: insights from tissue Doppler imaging.

Ventricular functional changes and mechanisms of the cardiovascular responses during static exercise have not been well delineated in children. In this study, Doppler echocardiographic techniques were utilized to assess cardiovascular adaptations to bilateral isometric leg extension at 30% maximal voluntary contraction for three minutes in a group of 14 healthy boys (mean age 10.2 +/- 1.5 years). Mean heart rate rose from 77 +/- 9 to 106 +/- 11 bpm, stroke volume fell from 59 +/- 9 to 52 +/- 7 ml, and cardiac output increased from 4.58 +/- 0.58 to 5.62 +/- 0.81 l min(-1) (P < 0.05). Mean arterial pressure rose from 86 +/- 7 to 109 +/- 9 mm Hg, with no significant change in peripheral vascular resistance. By tissue Doppler imaging markers, inotropic function improved by 59%, while lusitropic function increased 38%. These findings suggest that (1) cardiovascular responses to static leg extension in boys are similar to those in adult men, and (2) isometric leg extension triggers modest increases in both systolic and diastolic function.

Blood Pressure↗

Chronotropic response to exercise testing is associated with carotid atherosclerosis in healthy middle-aged men.

AIMS: Chronotropic incompetence, an attenuated heart rate (HR) response to exercise, is an independent predictor of cardiovascular mortality, but it is not known whether chronotropic incompetence is related to carotid atherosclerosis. The association between chronotropic incompetence and carotid atherosclerosis in 8567 (age 47.6+/-8.8 years) healthy men was examined. METHODS AND RESULTS: Chronotropic incompetence was defined as the failure to achieve 85% of the age-predicted maximal HR (APMHR), <80% HR reserve (HRR), and chronotropic response index (CRI). Carotid atherosclerosis was defined, using B-mode ultrasonography, as stenosis >25% and/or intima-media thickness (IMT) of >1.2 mm. In multivariable adjusted logistic regression models, the subjects who achieved less than 85% of APMHR exhibited an odds ratio (OR) of 1.72 [95% confidence intervals (CI): 1.32-2.22] for carotid atherosclerosis. Subjects with <80% of HRR were 1.45 (95% CI: 1.14-1.84) times more likely to have carotid atherosclerosis after multivariate adjustment. Also, the OR of carotid atherosclerosis across quartiles of CRI (highest to lowest) was 1.51 (95% CI: 1.10-2.09) after multivariate adjustment. CONCLUSION: These results suggest that the chronotropic response to exercise is associated with carotid atherosclerosis, independent of the established risk factors in healthy men, which could contribute to high incidence of cardiovascular diseases in subjects with chronotropic incompetence.

Arrhythmias, Cardiac↗

Adaptations in human neuromuscular function following prolonged unweighting: I. Skeletal muscle contractile properties and applied ischemia efficacy.

Strength loss following disuse may result from alterations in muscle and/or neurological properties. In this paper, we report our findings on human plantar flexor muscle properties following 4 wk of limb suspension (unilateral lower limb suspension), along with the effect of applied ischemia (Isc) on these properties. In the companion paper (Part II), we report our findings on the changes in neurological properties. Measurements of voluntary and evoked forces, the compound muscle fiber action potential (CMAP), and muscle cross-sectional area (CSA) were collected before and after 4 wk of unilateral lower limb suspension in adults (n = 18; 19-28 yr). A subset of subjects (n = 6) received applications of Isc 3 days/wk (3 sets; 5-min duration). In the subjects not receiving Isc, the loss in CSA and strength was as expected ( approximately 9 and 14%). We observed a 30% slowing in the duration of the CMAP, a 10% decrease in evoked doublet force, a 12% increase in the twitch-to-doublet force ratio, and an altered postactivation potentiation response (11% increase in the postactivation potentiation-to-doublet ratio). We also detected a 10% slowing in the ability of the plantar flexor to develop force during the initial phase of an evoked contraction, along with a 6% reduction in in vivo specific doublet force. In the Isc subjects, no preservation was observed in strength or the evoked muscle properties. However, the Isc group did maintain CSA of the lateral gastrocnemius, as the control subjects' lateral gastrocnemius atrophied 10.2%, whereas the subjects receiving Isc atrophied 4.7%. Additionally, Isc abolished the unweighting-induced slowing in the CMAP. These findings suggest that unweighting alters the contractile properties involved in the excitation-contraction coupling processes and that Isc impacts the sarcolemma.

Action Potentials↗

Effects of lifestyle modifications on C-reactive protein: contribution of weight loss and improved aerobic capacity.

High-sensitivity C-reactive protein (hs-CRP) is associated with an increased risk of cardiovascular disease and the development of type 2 diabetes mellitus. We analyzed the effects of lifestyle modifications including exercise training on hs-CRP in 47 overweight and obese adults. Subjects were divided into a lifestyle modification group (n=23) (exercise and diet instruction) and a control group (n=24) who did not participate in any lifestyle modification. After 3 months, body weight (80.8+/-11.5 to 73.5+/-10.7 kg, P<.01), total cholesterol (217+/-38.4 to 178.0+/-25.6 mg/dL, P<.01), low-density lipoprotein cholesterol (151.3+/-34.9 to 116.7+/-27.8 mg/dL, P<.01), Vo(2)peak (30.3+/-5.1 to 37.1+/-6.9 mL/[kg . min], P<.01), and log hs-CRP (0.75+/-0.4 to 0.56+/-0.3 mg/dL, P=.01) were significantly improved in the lifestyle modification group, but there was no significant improvement in the control group. Changes in log hs-CRP were associated with changes in Vo(2)peak (r=-0.41, P=.004) and changes in weight loss (r=0.42, P=.004). In stepwise multiple regression analysis, weight loss (P=.034) and improved Vo(2)peak (P=.039) were independent predictors of the changes in hs-CRP. When grouped into quartiles according to decreasing weight and increasing Vo(2)peak, levels of changes in log hs-CRP improved across quartiles of weight loss (P<.05) and improved Vo(2)peak (P<.01). Thus, lifestyle changes including regular exercise training in overweight and obese adults decreased hs-CRP, and this was associated with weight loss and improved Vo(2)peak.

Adult↗

Effects of exercise training on resting metabolic rate in postmenopausal African American and Caucasian women.

Ambiguous findings have been reported in previous studies concerning the relationships between resting metabolic rate (RMR), effects of exercise, and race in postmenopausal women. The purposes of this study were (1) to determine the effect of exercise training on RMR in postmenopausal women and (2) to determine whether this effect is different by race. We analyzed data from 24 African American (AA) (age, 56.3 +/- 5.0 years) and 23 Caucasian (CA) (age, 58.6 +/- 6.1 years) women. RMR was measured by indirect calorimetry after an overnight fast. Subjects completed tests of maximal exercise with metabolic measurements, waist to hip ratio, and body composition. At the completion of all tests, each subject was randomly assigned to either the exercise training or the control group. Aerobic exercise was performed 3 to 4 days per week for 6 months. Intensity was set at 70% to 85% maximal heart rate for 45 to 60 minutes per session. Both AA and CA exercise groups had a significant decrease (P < .05) in body weight (kilograms), percent body fat, and body mass index (BMI) and an increase in aerobic capacity, whereas the control groups did not change. There were no race effects. AA women exhibited significantly lower values than CA women for measured RMR (P < .05). The RMR (kilojoules) of the AA women (both control and exercise groups) decreased over time (P < .05), whereas the RMR of the CA women did not change. Adjusting RMR for BMI or for changes in lean body mass and fat mass did not alter these results. In conclusion, this 6-month endurance-training program did not affect RMR in these postmenopausal women, as RMR did not change in CA women, but decreased significantly over time in both groups of AA women. The factors that contribute to these findings should be the focus of future studies.

Aged↗

Exaggerated blood pressure response to exercise is associated with carotid atherosclerosis in apparently healthy men.

OBJECTIVE: Although an exaggerated systolic blood pressure (SBP) response to exercise is a predictor of future hypertension and cardiovascular mortality, the underlying mechanisms are not fully understood. We tested the hypothesis that an exaggerated SBP response is associated with carotid atherosclerosis in a cross-sectional study of 9073 healthy men (aged 47.8 +/- 8.8 years). METHODS: Exaggerated SBP response was defined as an SBP of 210 mmHg or greater during a maximal treadmill test. Carotid atherosclerosis was defined as stenosis greater than 25% or intima-media thickness greater than 1.2 mm using B-mode ultrasonography. RESULTS: An exaggerated SBP response was present in 375 men (4.1%). The proportion of individuals with carotid atherosclerosis in the group with an exaggerated SBP response to exercise was higher than in the group with a normal SBP response (14.4 versus 5.3%, P < 0.001). In a multivariable logistic regression model, individuals with an exaggerated SBP (>or= 210 mmHg) response to exercise had a 2.02 times [95% confidence interval (CI) 1.33-3.05] increased risk of carotid atherosclerosis compared with individuals with an SBP response of less than 210 mmHg. The highest quartile (> 61 mmHg) group of relative exercise-induced increases in SBP showed a 1.57 (95% CI 1.18-2.08) greater risk of carotid atherosclerosis compared with individuals in the lowest quartile (< 38 mmHg) in the adjusted model. CONCLUSIONS: These results suggest that an exaggerated SBP response to exercise is strongly associated with carotid atherosclerosis, independent of established risk factors in healthy men. It may be an important factor in evaluating hypertension related to target-organ damage.

Adult↗

Cardiac autonomic modulation during recovery from acute endurance versus resistance exercise.

BACKGROUND: The kinetics of parasympathetic reactivation after dynamic endurance exercise have been well elucidated. However, autonomic recovery of cardiac function after resistance exercise is not known. PURPOSE: The purpose of this study was to assess cardiac autonomic modulations during recovery from acute resistance exercise versus acute endurance exercise. METHODS: Electrocardiogram readings were collected before and 30 min after a single bout of endurance or resistance exercise in 14 male participants (aged 25.3+/-2.5 years). Heart rate (HR) variability was spectrally decomposed using an autoregressive approach. High frequency (HF) power was considered representative of vagal modulation. All values were expressed in both absolute and normalized units (normalized for change in total power). RESULTS: A mode-by-time interaction (P<0.05) was detected for HR, which remained elevated to a greater extent after resistance exercise. Total power was significantly reduced after resistance exercise (P<0.05) but not endurance exercise. An interaction (P<0.05) was also detected for both a change in absolute natural log function HF power and natural log function low frequency (LF) power (P<0.05), as both variables decreased more after resistance exercise. When normalized for changes in total power, interactions in LF and HF power were lost. The LF/HF ratio was significantly increased after both resistance and endurance exercise (P<0.05). CONCLUSION: Greater elevations in HR after acute resistance exercise versus acute endurance exercise may be related to greater reductions in cardiac parasympathetic tone.

Adult↗

Heart rate variability during recovery from a Wingate test in adolescent males.

PURPOSE: To evaluate the effect of maturity status on the autonomic nervous system at rest and recovery after short-term, high-intensity exercise in adolescents. METHODS: A biological maturity age was estimated in 27 males by calculating the years from peak height velocity (PHV) using a multiple regression equation. Subjects were divided into two groups: pre-PHV (years from PHV < 0.49), N = 14, mean age = 12.29 +/- 0.91 yr; post-PHV (years from PHV > 0.5, N = 13, mean age = 15.12 +/-0.76 yr). HR variability was used to evaluate autonomic function. ECG tracings were collected during 5 min at rest and recovery after a Wingate test and were analyzed in the frequency domain (low-frequency (LF), high-frequency (HF), LF/HF, total power (TP)). Data are presented as natural logarithms (LN). RESULTS: Changes in HR from HR(peak) during exercise to HR measured at minute 4 after exercise ([DELTA]HR4) were significantly greater in the pre-PHV group (84.31 +/-17.58 bpm) compared with the post-PHV group (69.42 +/-17.63 bpm). There were no significant differences in resting HR variability between pre- and post-PHV groups (P > 0.05). Significant group x time interactions were found for LF(LN) (ms(2)) and TP(LN) (ms(2)) measured during recovery (P < 0.05). Post hoc tests showed that the pre-PHV group had significantly higher postexercise LF(LN) (5.02 +/- 0.97 vs 4.19 +/- 0.79) and TP(LN) (6.36 +/- 1.02 vs 5.62 +/- 0.65) compared with the post-PHV group. When postexercise LF(LN) (ms(2)) was normalized for TP(LN) (ms(2)), there were no significant differences between groups (P > 0.05). CONCLUSION: The pre-PHV group had higher total HR variability than the post-PHV group after a Wingate test, suggesting that maturity status significantly affects total HR variability during recovery after high-intensity exercise.

Adolescent↗

Tissue Doppler assessment of ventricular function during cycling in 7- to 12-yr-old boys.

PURPOSE: Studies utilizing submaximal supine exercise have indicated that tissue Doppler imaging (TDI) may be useful for assessing ventricular systolic and diastolic function during exercise and might offer a means of detecting patients with early myocardial dysfunction. This investigation of 14 healthy boys ages 7-12 yr was designed to assess measures of inotropic and lusitropic function during maximal upright cycle exercise. METHODS: Color tissue Doppler imaging (S and E' waves, indicative of systolic and diastolic function, respectively), stroke volume, and mitral peak inflow velocity (E wave) were recorded at rest and during a progressive upright cycle test to exhaustion. RESULTS: Values of TDI-S and TDI-E' were obtained at exhaustive exercise in all but one subject. Mean value of S rose 163% (3.8+/-1.2 to 10.0+/-2.5 cm.s), and average E' increased by 92% (-6.3+/-2.2 to -12.1+/-3.2 cm.s). No significant changes were observed in the ratio of E' to mitral peak flow velocity (E), suggesting that left ventricular end-diastolic pressure remained stable. CONCLUSIONS: These data indicate that measurement of TDI is feasible during maximal upright exercise, and velocities obtained may provide insights into ventricular systolic and diastolic functional capacity.

Bicycling↗

Cardiac autonomic control in individuals with Down syndrome.

Our goal in this study was to compare cardiac autonomic control at rest between 50 individuals with Down syndrome and 24 control participants without disabilities. Resting autonomic function was assessed using analysis of heart rate variability. Participants with Down syndrome had reduced total heart rate variability, which indicates possible autonomic dysfunction in this population. Their VO2 peak and BMI were not significantly correlated with resting cardiac autonomic control. This may suggest that fitness level and obesity differentially affect cardiac autonomic control in persons with Down syndrome compared to their healthy, nondisabled peers.

Adult↗

Impaired vagal modulation of heart rate in individuals with Down syndrome.

The attenuated heart rate (HR) and blood pressure (BP) response to exercise in individuals with Down syndrome (DS) has been attributed to autonomic dysfunction, which has been associated with obesity. Our purpose was to determine the role of autonomic control of HR to the attenuated chronotropic response observed in individuals with DS. We evaluated spectral analysis of HR variability (HRV) in 13 individuals with (BMI 32+/-5 kg/m(2), P<0.05) and 14 without DS (BMI 26+/-3 kg/m(2)) by means of 2 min isometric handgrip at 30% of maximal force followed by recovery. Noninvasive measures of HR (ECG) and systolic BP (SBP) (Portapres) were recorded continuously. The increases in HR and SBP, and decrease in high frequency (HF) component were significantly greater in controls than in individuals with DS (P<0.05) during handgrip. The increase in LF/HF ratio was not significantly affected by handgrip and was comparable in both groups. During recovery, the decreases in HR, SBP, and LF/HF ratio, and the increase in HF were significantly greater in controls than in individuals with DS (P<0.05). Controlling for BMI did not alter these results. The attenuated HR and SBP response to the handgrip test in individuals with DS is explained by blunted vagal modulation. Our study suggests that autonomic dysfunction in individuals with DS might be independent of obesity.

Adolescent↗

Blunted heart rate response to upright tilt in people with Down syndrome.

OBJECTIVES: To determine whether heart rate and blood pressure responses to upright tilt would be lower in subjects with Down syndrome (DS) than in control subjects with no disabilities. DESIGN: Comparative study. SETTING: University research laboratory. PARTICIPANTS: Nineteen people with DS (mean age, 25.1+/-7.3 y) and 17 control subjects without disabilities (mean age, 28.4+/-5.6 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Heart rate and blood pressure recordings were obtained at rest and during a 2-minute period of passive head up tilt to 80 degrees . RESULTS: Heart rate and blood pressure increased significantly during the first 30 seconds of upright tilt in both groups ( P <.05) and then stabilized for the remainder of the test. The initial heart rate response to head up tilt (first 30s) was significantly higher in controls compared with subjects with DS ( P <.05), whereas the blood pressure response did not differ between groups ( P >.05). Controlling for heart rate reserve showed a blunted heart rate response through the tilt period in subjects with DS. CONCLUSIONS: These data show a blunted heart rate response to upright tilt in people with DS, despite similar changes in blood pressure, consistent with reduced sympathoexcitation and possibly altered baroreceptor function in these people with DS.

Adolescent↗

Effects of diet and/or exercise on the adipocytokine and inflammatory cytokine levels of postmenopausal women with type 2 diabetes.

This study examined the independent and combined effects of diet and exercise on adipocytokine and inflammatory cytokines in postmenopausal women with type 2 diabetes. Using a randomized, controlled design, 33 women (age, 50-70 years) were assigned to diet alone (D), exercise alone (EX), or diet + exercise (D + E) for 14 weeks. Before and after the interventions, blood samples for adipocytokines and inflammatory markers were drawn, a meal test was performed, and abdominal fat distribution was measured by magnetic resonance imaging (MRI). Body weight decreased approximately 4.5 +/- 0.6 kg ( P < .05) after the D and D + E interventions, whereas only small changes in body weight were found with the exercise-alone intervention. Plasma C-reactive protein levels were decreased by approximately 15% with all 3 interventions, whereas leptin levels were reduced with the D and D + E intervention (D: pre = 48.7 +/- 6.0, post = 38.9 +/- 5.0 ng/mL; D + E: pre = 38.5 +/- 6.0, post = 22.9 +/- 5.0 ng/mL; P < .05) with no differences between groups. There was a trend for leptin levels to decrease in the EX group ( P = .06). Plasma resistin levels were not altered by the 3 interventions from pre- to posttreatment (D: pre = 6.9 +/- 0.6, post = 6.2 +/- 0.4 ng/mL; D + E: pre = 5.6 +/- 0.6, post = 5.7 +/- 0.4 ng/mL; E: pre = 6.2 +/- 0.6, post = 5.9 +/- 0.6 ng/mL, P > .05), and no differences in adiponectin and tumor necrosis factor alpha (TNF- alpha ) levels were found. Visceral adipose tissue and tumor necrosis factor alpha were the only predictors of calculated insulin resistance ( P < .05), explaining 43% of the variability. A typically prescribed weight loss program with lifestyle changes resulted in few changes in adipocytokines and inflammatory cytokines in older women with type 2 diabetes, suggesting that dramatic weight loss or clinical interventions are needed.

Aged↗

Baroreflex sensitivity during static exercise in individuals with Down Syndrome.

INTRODUCTION: Individuals with Down syndrome (DS) have altered heart rate (HR) and blood pressure (BP) responses to orthostatic challenges and isometric handgrip (IHG) exercise, suggesting possible alteration in baroreflex sensitivity. PURPOSE: This study investigated baroreflex sensitivity (BRS) as a potential mechanism contributing to chronotropic incompetence during IHG in persons with DS. METHODS: Heart rate and BP were continually recorded in 12 individuals with DS and 10 controls, at rest and during 2 min of IHG, at 30% of maximal voluntary contraction (MVC). Spontaneous BRS was derived via the sequence method. RESULTS: No differences were seen in HR at rest between groups. Systolic BP (SBP) was significantly lower in the DS group at rest (106.1+/- 2.9 vs 116.5+/- 3.9 mm Hg, P < 0.05) and during IHG (123.9+/- 4.6 vs 150.1+/- 5.3 mm Hg, P<0.001). A significant group-by-task interaction was found for both change in HR and change in SBP with IHG, because of an attenuated HR and SBP response to IHG in participants with DS (P<0.05). When controlling for resting SBP, the DS group had a lower BRS at rest (16.0+/-1.7 vs 21.2+/-4.2 ms.mm Hg, P< 0.05) and during IHG (7.8 +/-1.0 vs 12.1+/- 2.6 ms.mm Hg, P< 0.05). CONCLUSIONS: Individuals with DS have lower BRS at rest and during IHG than controls and this may be related to their attenuated HR response during perturbation.

Adult↗

Resting metabolic rate is not reduced in obese adults with Down syndrome.

Resting metabolic rate (RMR) of 22 individuals with Down syndrome was compared to that of 20 nondisabled control individuals of similar age (25.7 and 27.4 years, respectively). Using a ventilated hood system, we measured RMR in the early morning after an overnight fast. Peak aerobic capacity (VO2peak) and body composition were also determined. Resting metabolic rate was not different between groups. Adjusting RMR for body weight or body surface area did not change these findings. Using stepwise regression for the total population and each subgroup, we found that only body surface area was a significant predictor of RMR. These data show that individuals with Down syndrome do not have lower RMR than their nondisabled peers, suggesting that reduced RMR does not explain the high incidence of obesity in this population.

Adolescent↗

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

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.

Cardiovascular Diseases↗