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Even if the effects of physical training on secondary prevention are controversial, it is known that exercise may influence several of the risk factors for coronary heart disease (CHD). One of the most important is cholesterol. Studies conducted to determine the influence of training on lipid profile have shown in normals, as well as in CHD patients, a favourable influence: a small decrease in total cholesterol and low-density lipoprotein cholesterol, and an increase in high-density lipoprotein cholesterol. These results are obtained after prolonged and intensive training. The influence of training on coagulation is more controversial and less well known. During short bouts of exercise the following changes are generally observed: an increase in platelet count and platelet aggregation (the effects on platelet adhesiveness and activation are controversial), potentiation of coagulation with an increase in factor VIII, and an increase in fibrinolytic activity due to an increase in plasminogen activator level. The effects of training have been less well studied. It is supposed that training could diminish the clotting potentiation observed during short exercise. Fibrinolysis is also increased in these conditions. If the influence of training on blood lipid profile may be considered as favourable in secondary prevention, no study has yet assessed the role of training on coagulation factors in secondary prevention.
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