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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
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Orthostatic Challenge-Induced Coagulation Activation in Young and Older Persons
Axel Schlagenhauf1, Bianca Steuber2, Markus Kneihsl3
1Department of Paediatrics and Adolescent Medicine, Division of General Paediatrics, Medical University of Graz, 8036 Graz, Austria.
Biomedicines
|November 11, 2022
Summary
Older adults do not show a hypercoagulable state at rest. Their fibrinolytic system is more active, and younger individuals show greater coagulation changes during orthostasis.
Area of Science:
- Gerontology
- Hematology
- Physiology
Background:
- Thrombosis incidence rises with age.
- Aging may be associated with a hypercoagulable state.
- Orthostasis (standing) can impact coagulation.
Purpose of the Study:
- Investigate the coagulatory/hemostatic system across different age groups.
- Test if older individuals exhibit a hypercoagulable state at rest.
- Determine if orthostasis causes greater coagulation changes in older adults.
Main Methods:
- 22 older and 20 younger participants underwent a 6-minute sit-to-stand test.
- Blood samples collected pre- and post-orthostatic challenge.
- Hemostatic profiling using thrombelastometry (TEM), calibrated automated thrombogram (CAT), and standard coagulation assays.
Main Results:
- Baseline: Older adults showed enhanced thrombin generation (CAT), but prolonged TEM coagulation times and prothrombin times (PTs).
- Baseline: Older adults exhibited higher fibrinolytic activity (lower TF, higher t-PA).
- Orthostasis: Younger participants showed greater increases in endogenous thrombin potential (CAT) and PT shortening.
Conclusions:
- Increased thrombosis risk in older adults is not primarily due to a hyperactive coagulation cascade.
- Older adults possess enhanced fibrinolytic capacity.
- Younger individuals exhibit greater sensitivity to orthostatic challenges regarding coagulation changes.
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