What Is a Hypercoagulable State?
Blood Health Data Verified

Hypercoagulable State: An Overview

Published on Dec 26, 2022   -  4 min read


A hypercoagulable state is a condition that increases the body’s tendency to make more blood clots. Read this article to learn more about the condition.

What Is a Hypercoagulable State?

A hypercoagulable state is also known as thrombophilia. It is a condition characterized by an increased tendency of the body to form blood clots (thrombosis) due to one or more predisposing factors. These factors can either be inherited or acquired. In a normal state, clot formation is a good thing. It ensures that the body can cope with injuries and heal independently.

However, blood clots can become dangerous when developing within the blood vessels. Therefore, individuals in a hypercoagulable state are at an increased risk of developing thrombus formation within the veins, such as deep vein thrombosis or pulmonary embolism. Deep vein thrombosis is characterized by developing a clot in a deep vein of the upper and lower extremities, which usually presents with swollen and painful limbs. Pulmonary embolism occurs when parts of these blood clots from the vein break off and reach the lungs. On the other hand, arterial clots can travel to other organs like the brain, bones, heart, kidneys, and liver, thereby cutting off blood supply to these organs. This leads to infarction (local death of the tissue).

What Causes Hypercoagulability?

Blood clotting occurs due to the interaction between blood vessels, platelets, and clotting factors. Clotting factors circulate in their inactive form in the blood to prevent coagulation from occurring when it is not required. When an injury occurs, clotting factor VII binds to the exposed vessel wall cells, triggering the coagulation cascade's activation. This often leads to subsequent activation of the other clotting factors, ultimately forming thrombin (factor II). Thrombin, in turn, converts fibrinogen into fibrin, thereby forming a mesh to stabilize the platelet plug.

To limit clot formation at the injury site and prevent it from growing very big, the coagulation cascade is mediated by different anticoagulant mechanisms. Any condition that strikes an imbalance between thrombogenic and anti-thrombogenic mechanisms makes the person susceptible to an increased risk of bleeding (state of hypercoagulability).

What Is a Primary Hypercoagulable State?

The primary hypercoagulable state is an inherited type of clotting disorder in which the natural anticoagulant mechanism is defective.

What Is a Secondary Hypercoagulable State?

A secondary hypercoagulable state develops when clot formation is caused by acquired factors that can increase the chance of clot formation. These factors include neoplasms, smoking, excessive fat deposition, pregnancy, major injury or surgery, autoimmune disorders, and consumption of certain medicines like oral contraceptives. Cancer leads to an increased generation of procoagulant factors and cytokines, causing hypercoagulation. Other conditions like smoking, surgery, or severe injury cause damage to the blood vessels, thereby activating the coagulation cascade.

Is Pregnancy a Hypercoagulable State?

During pregnancy, there is a higher risk of venous thromboembolism (blood clots in the veins). This occurs due to hormonal and physical changes occurring during pregnancy. Increased clotting factors and womb pressure reduce the venous return into the heart. This makes the blood clot more easily.

What Are the Symptoms of a Hypercoagulable State?

The symptoms of a hypercoagulable state depend on blood clots in the body. Symptoms may include:

  • Swelling of the legs.

  • Tenderness in the legs.

  • Pain in the legs.

  • Chest pain.

  • Breathlessness.

  • Heart attack.

  • Stroke (damage to the brain due to disruption in the blood supply).

How to Diagnose a Hypercoagulability State?

The diagnostic tests for blood clotting include

  • Prothrombin Time: This test helps the healthcare provider monitor the condition if the patient is on Warfarin. PT test helps to determine the time taken for a clot formation in a blood sample.

  • Activated Partial Thromboplastin Time (aPTT): It measures the time the blood takes to clot. The healthcare provider may monitor the situation well.

  • Fibrinogen Test: This test helps determine the blood's fibrinogen levels. Fibrinogen is a protein that helps in blood clotting.

  • Complete Blood Count (CBC): This test helps determine the different blood features.

Some tests that help to diagnose inherited coagulation disorders include

  • Genetic Mutation Tests- These include prothrombin gene mutation and activated protein C resistance.

  • Antithrombin Activity- Antithrombin acts to thin the blood slightly, so it does not clot easily.

  • Protein C Activity- Protein C helps to control blood coagulation.

  • Protein S Activity- This protein blocks the activity of certain proteins that promote blood clot formation.

  • Homocysteine Test- This test measures the amount of homocysteine, an amino acid, in the body. Higher levels suggest a high risk of heart disease.

How to Manage a Hypercoagulable State?

Treatment of a hypercoagulability state is usually recommended after a thromboembolic event has occurred in individuals with a known clotting disorder.

Short-term anticoagulant therapy with medications such as low molecular weight Heparin, Warfarin, or direct anticoagulants is preferred in acute thromboembolic situations. In severe conditions, the clot is surgically removed through thrombectomy (clot removal surgery from a vein or artery) or dissolved with fibrinolytic medications like urokinase or streptokinase. Long-term anticoagulant therapy is prescribed in such individuals to inhibit the clotting cascade and prevent the formation of clots. These medications may also be prescribed in high-risk people, such as during pregnancy or after major surgery or trauma.

It is also important to avoid risk factors that may lead to developing a hypercoagulable state when possible. These preventive measures include substituting oral contraceptive pills for another birth control method and cessation of smoking.


To conclude, staying in touch with the healthcare provider is crucial if a patient suffers from a blood clotting disorder. The patient should not miss the follow-up appointments. No over-the-counter medicines should be purchased without a doctor’s prescription. If the blood clotting disorder is inherited, the condition may remain life-long. Still, if it is acquired, the patient's condition might improve after eliminating the underlying pathology.

Frequently Asked Questions


How to Recognise Hypercoagulable State?

A hypercoagulable state can be identified by a personal or family history of blood clots, venous or arterial thrombosis, unexplained recurrent miscarriages, or laboratory tests that measure clotting factors and function.


What Does the Term "Hypercoagulable State" Mean?

A hypercoagulable state, also identified as thrombophilia, is a medical condition in which the blood has an increased predisposition to clot. This can result in blood clots forming in veins or arteries, leading to Deep vein thrombosis, pulmonary embolism, and stroke, all serious medical conditions. Genetic factors, acquired conditions, or a combination can cause it.


What Is the Treatment for Hypercoagulable State?

Treatment for hypercoagulable states varies according to the underlying cause and may include anticoagulant medications, lifestyle changes, and surgical interventions.


How to Restore Hypercoagulable Status?

Intentionally restoring a hypercoagulable state is not recommended because this medical condition increases the risk of developing blood clots. Deep vein thrombosis, pulmonary embolism, and stroke are severe medical conditions. Instead, the emphasis should be on treating the underlying cause of the hypercoagulable state and preventing blood clot formation through appropriate medical treatment and lifestyle changes.


What Are Some of the Most Common Hypercoagulable States?

Common hypercoagulable states include genetic mutations like Factor V Leiden, deficiencies of natural anticoagulants like Protein C or S, an autoimmune disorder like Antiphospholipid syndrome, elevated homocysteine levels, and some types of cancer.


Is Hypercoagulable State Chronic?

Yes, hypercoagulability can be chronic. In some cases, the underlying cause of hypercoagulability is a genetic or acquired condition that interferes with the body's natural clotting process, increasing the risk of blood clots on an ongoing or recurring basis. This can lead to a chronic hypercoagulable state that may necessitate ongoing monitoring and treatment to avoid complications.


Is Chronic Hypercoagulable State Curable?

Chronic hypercoagulable states are not typically curable, as they are usually caused by genetic or acquired conditions that cannot be fully reversed. However, the condition can be managed with appropriate medical treatment and lifestyle modifications to reduce the risk of blood clots and their complications.


Which Labs Demonstrate Hypercoagulability?

Several laboratory tests can be used to diagnose hypercoagulability or thrombophilia. International normalized ratio (INR), Prothrombin time (PT), and activated partial thromboplastin time (APTT) are all measurements.), D-dimer test, fibrinogen level, antithrombin III activity, protein C and protein S levels, factor V Leiden mutation analysis, and antiphospholipid antibody test are all tests that can help evaluate clotting factors and functions. The specific tests ordered may be determined by the patient's medical history, symptoms, and suspected cause of hypercoagulability. The results of these tests can help guide appropriate medical treatment and condition management.


What Are the Initial Symptoms of a Blood Clot?

The initial symptoms of a blood clot can vary depending on where the clot is located in the body. For example: 
- Swelling, warmth, and redness in the affected area; pain or tenderness; skin discoloration; difficulty moving the affected area.
- Chest pain, shortness of breath, and rapid heartbeat in the case of a blood clot in the lungs. 
- Sudden weakness, numbness, or tingling face, arm, or leg, particularly over one side of one's body, in the case of a blood clot in the brain are some common symptoms.
- One experiencing any of these symptoms should seek medical attention right away., especially if one has risk factors for blood clots. Early detection and treatment are essential for avoiding serious complications.


What Causes Blood Clots?

Injury, atherosclerosis, hypercoagulability, immobility, and surgery or medical procedures can all cause blood clots. They occur when the blood's natural clotting process is inappropriately triggered, forming a clot.


What Is the Term for Being Prone to Blood Clots?

Thrombophilia is the medical term for being prone to blood clots. Thrombophilia is a condition in which a person has an increased predisposition to form blood clots due to a genetic or acquired abnormality in the coagulation system. This increases the risk of blood clots in veins or arteries, which can lead to serious medical complications.


What Factors Promote Blood Clotting?

Several factors can contribute to blood clotting. These are some examples: Platelets are small blood cells essential in forming blood clots. When a blood vessel is damaged, they become activated and release chemicals that attract more platelets to the injury site, resulting in clot formation. In addition, the blood contains several clotting proteins that work together to form a clot.


Is Having a Lot of Clots Normal?

No, having a large number of clots is not normal. When a blood vessel is injured or damaged, blood clots are a natural part of the healing process. However, when blood clots form abnormally or excessively, they can cause serious medical complications such as deep vein thrombosis, pulmonary embolism, stroke, or heart attack. If one is concerned about their risk of blood clots, speak with the doctor about the risk factors and any potential preventative measures one can take.

Last reviewed at:
26 Dec 2022  -  4 min read




Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Anticoagulation in Chronic Kidney Disease

Article Overview: Anticoagulation is important in patients with chronic kidney disease as they are at increased risk of thromboembolic events. Read further to know more. Read Article

Introduction: Chronic kidney disease (CKD) patients are at an increased risk of thromboembolic events due to the hypercoagulable state of the blood as a result of altered homeostatic mechanisms. More than 15 % of patients with CKD are at an increased risk of atrial fibrillation as a result of increa...  Read Article

Ambulatory Phlebectomy - Indications, Contraindications, Procedure, and Complications

Article Overview: Ambulatory phlebectomy is a surgical procedure for removing varicose veins found near the skin surface. Refer to this article to know in detail. Read Article

Shivpal Saini
Shivpal Saini
General Surgery

Introduction: The reflux generates venous insufficiency in the circuit due to the defect in the primary valves in the location of the saphenofemoral junction, and thus this causes superficial varicose veins. Varicose veins that separate from a saphenous vein, which is incompetent, are known as branc...  Read Article

What causes recurrent miscarriages?

Query: Hi doctor, At first, I ended up with miscarriage in 8 months. It was a natural one when the baby movement got less and I was unable to determine. Then, after eight months I conceived. That also ended with a miscarriage in a month's time. I have gone through D and C. Now, I have been trying to concei...  Read Full »

Popular Articles Most Popular Articles

Do you have a question on Hypercoagulable States or ?

Ask a Doctor Online

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.