Long-term treatment with ramipril favourably modifies the haemostatic response to acute submaximal exercise in hypertensives

• Main Authors: Vassiliki Galea, Helen Triantafyllidi, Theodoros Theodoridis, Matina Koutroumbi, Vasiliki Christopoulou-Cokkinou, Dimitrios Kremastinos, Maria Anastasiou-Nana, John Lekakis
• Format: Article
• Language: English
• Published: Hindawi - SAGE Publishing 2013-12-01
• Series: Journal of the Renin-Angiotensin-Aldosterone System
• Online Access: https://doi.org/10.1177/1470320312466125

Introduction: Hypertension links to a prothrombotic state driven by endothelial dysfunction, reduced fibrinolytic potential and platelet hyperactivity. We hypothesized that ramipril treatment would favourably modify the haemostatic response to a submaximal aerobic exercise session in hypertensives. Methods: Twenty-four hypertensive patients underwent a submaximal exercise test before and after 13±2 months of treatment with ramipril ± hydrochlorothiazide. Hypercoagulability (prothrombin fragments [PF1+2], thrombin– antithrombin complex [TAT] and D-dimers [Dd]), fibrinolytic activity (plasmin–a2-antiplasmin complex [PAP]), endothelial function (von Willebrand factor [vWf] and soluble thrombomodulin [sTM]), and platelet function (soluble P-selectin [sPsel]) were measured before, at peak and one hour after exercise. Results: Antihypertensive treatment resulted in an increase of PAP, vWf and sTM. During the first exercise, PF1+2 were mildly increased at peak exercise ( p <0.05), while D-dimers, PAP and vWf varied significantly throughout the exercise ( p <0.001). During the second exercise session, PF1+2 were decreased post-exercise ( p <0.05), PAP was increased at peak and post-exercise ( p <0.001) and vWf was increased at peak ( p <0.05) and post-exercise ( p <0.001). Conclusions: The haemostatic response to exercise in hypertensives after approximately one year of ramipril treatment is characterized by the attenuated activation of coagulation, enhanced fibrinolysis and endothelial activation.