@article{3088769,
    title = "Long-term treatment with ramipril favourably modifies the haemostatic response to acute submaximal exercise in hypertensives",
    author = "Galea, V. and Triantafyllidi, H. and Theodoridis, T. and Koutroumbi, M. and Christopoulou-Cokkinou, V. and Kremastinos, D. and Anastasiou-Nana, M. and Lekakis, J.",
    journal = "JRAAS - Journal of the Renin-Angiotensin-Aldosterone System",
    year = "2013",
    volume = "14",
    number = "4",
    pages = "322-329",
    doi = "10.1177/1470320312466125",
    keywords = "alpha 2 antiplasmin;  antiplasmin;  D dimer;  hydrochlorothiazide;  PADGEM protein;  prothrombin;  prothrombin fragment 1+2;  ramipril;  thrombin antithrombin complex;  thrombomodulin;  unclassified drug;  von Willebrand factor, adult;  aerobic exercise;  antihypertensive therapy;  article;  blood pressure;  clinical article;  female;  fibrin formation;  fibrinolysis;  hematological parameters;  hemostasis;  human;  hypercoagulability;  hypertension;  long term care;  male;  outcome assessment;  thrombocyte function;  treatment response;  vascular endothelium, acute submaximal exercise;  endothelium;  Essential hypertension;  haemostasis;  renin-angiotensin aldosterone system antagonists, Blood Platelets;  Blood Pressure;  Demography;  Endothelium, Vascular;  Exercise;  Fibrin;  Fibrinolysis;  Hemostasis;  Humans;  Hypertension;  Male;  Middle Aged;  Ramipril;  Thrombin;  Time Factors",
    abstract = "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. © The Author(s) 2012."
}