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The hemostatic system through aging and menopause.
1A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Medical Specialties, University of Milan and IRCCS Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena Foundation, Milan, Italy.
Climacteric : the Journal of the International Menopause Society
|October 9, 2009
Summary
Aging alters the hemostatic system, increasing thrombosis risk. However, healthy centenarians show similar coagulation patterns, suggesting hypercoagulability is compatible with longevity.
Area of Science:
- Gerontology
- Hematology
- Cardiovascular Medicine
Background:
- Aging involves significant changes in the hemostatic system, affecting blood coagulation, fibrinolysis, platelet activity, and vascular endothelium.
- These age-related hemostatic modifications are associated with an increased incidence of arterial and venous thrombosis in older adults.
- Factors like genetics, diet, smoking, exercise, hormonal status, and low-grade inflammation influence hemostasis during aging.
Purpose of the Study:
- To investigate the relationship between aging, hemostatic system changes, and thrombosis risk.
- To explore the hemostatic profiles of healthy centenarians in relation to aging.
- To determine the clinical utility of hemostasis laboratory parameters in predicting thrombosis in elderly patients.
Main Methods:
- Review of existing literature on hemostasis and aging.
- Analysis of hemostatic system components (coagulation, fibrinolysis, platelets, endothelium).
- Comparison of coagulation activation patterns in aging individuals and centenarians.
Main Results:
- Aging is associated with a hypercoagulable state, contributing to increased thrombosis risk.
- Healthy centenarians exhibit a coagulation activation pattern similar to younger individuals, indicating compatibility with longevity.
- Current laboratory hemostasis parameters are not individually predictive of thrombosis.
Conclusions:
- While aging increases thrombosis risk due to hemostatic changes, a hypercoagulable state can be compatible with health and longevity.
- Clinical decisions regarding thrombosis risk in aging patients should prioritize clinical history and established risk factors over laboratory hemostasis tests.
- Physician management should focus on comprehensive patient assessment rather than solely relying on hemostasis markers.
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