Chen Yu-Wen, Apostolakis Stavros, Lip Gregory Y H
Haemostasis, Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Science, City Hospital , Birmingham , United Kingdom.
Ann Med. 2014 Nov;46(7):439-55. doi: 10.3109/07853890.2014.927713. Epub 2014 Jul 11.
Sedentary lifestyle is a risk factor and a strong predictor for chronic disease and premature death. Low-grade inflammation has been proved a key player in the pathogenesis of cardiovascular disease. Inflammatory processes have been also involved in maintaining the balance between coagulation and fibrinolysis. In addition, an inverse linear dose-response relation between physical activity and mortality risks has also been reported. However, the favorable effects of structured exercise programs and the independent contribution of physical activity to cardiovascular risk are still under investigation. In response to heavy exercise, interleukin-6 (IL-6) is secreted by contracting skeletal muscles, followed by an acute reactant release of C-reactive protein (CRP). Both CRP and IL-6 can stimulate monocyte tissue factor production, provoke platelet hyperreactivity, promote fibrinogen biosynthesis, and enhance microparticle formation and erythrocyte aggregability, thus triggering prothrombotic state. By contrast, regular exercise and physical activity are protective against all-cause mortality through suppressing pro-inflammatory cytokine production, enhancing anti-inflammatory mediators and antioxidant development, and promoting fibrinolytic activity. Low-load resistance exercise also plays an advantageous role in thrombogenesis by reducing inflammatory processes and potentiating fibrinolytic features. In the present review article, we provide an overview of the impact of different modes and intensities of physical activity on vascular inflammation and thrombogenesis.
久坐不动的生活方式是慢性病和过早死亡的一个风险因素及强有力的预测指标。低度炎症已被证明是心血管疾病发病机制中的关键因素。炎症过程也参与维持凝血与纤溶之间的平衡。此外,也有报道称身体活动与死亡风险之间存在负向线性剂量反应关系。然而,结构化运动计划的有益效果以及身体活动对心血管风险的独立作用仍在研究之中。在剧烈运动时,收缩的骨骼肌会分泌白细胞介素-6(IL-6),随后会急性释放C反应蛋白(CRP)。CRP和IL-6均可刺激单核细胞组织因子生成,引发血小板高反应性,促进纤维蛋白原生物合成,并增强微粒形成和红细胞聚集性,从而引发血栓前状态。相比之下,规律运动和身体活动可通过抑制促炎细胞因子生成、增强抗炎介质和抗氧化物质生成以及促进纤溶活性来预防全因死亡。低负荷抗阻运动通过减轻炎症过程和增强纤溶特性,在血栓形成方面也发挥着有利作用。在本综述文章中,我们概述了不同方式和强度的身体活动对血管炎症和血栓形成的影响。