Framingham Heart Study

There was a time when most doctors believed that heart disease was an inevitable “wearing down” down of the body and hardly could anyone do something about it. Hearts are like car engines; as one got older, the parts did not work as well and sometimes gave out. What if the disease could be seen in advance by measuring risk factors?

The Framingham Heart Study (FHS) started in Framingham in 1948 under the direction of the National Heart, Lung and Blood Institute (NHLBI), formerly known as the National Heart Institute. It has been committed to identifying the common factors or characteristics that contribute to cardiovascular disease (CVD). The Study has followed CVD development over a long period of time in three generations of participants.

The Study began by recruiting an Original Cohort (study group) of 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachusetts, who had not yet developed overt symptoms of cardiovascular disease or suffered a heart attack or stroke. The Study later added an Offspring Cohort. The Offspring Cohort was initiated in 1971 when the need for establishing prospective epidemiological study of young adults was recognized. A sample of 5,124 men and women, consisting of the offspring of the Original Cohort and their spouses was recruited.

There are six groups of participants in the FHS: Original Cohort, Offspring Cohort, Third Generation Cohort, New Offspring Spouse Cohort, Omni Generation 1 Cohort and Omni Generation 2 Cohort. Over the years, careful monitoring of the Framingham Study population has led to the identification of the major CVD risk factors – high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity – as well as a great deal of valuable information on the effects of related factors such as blood triglyceride and HDL cholesterol levels, age, gender, and psychosocial issues. Although the Framingham cohort is primarily Caucasian, the importance of the major CVD risk factors identified in this group have been shown in other studies to apply almost universally among racial and ethnic groups, even though the patterns of distribution may vary from group to group. The Study has produced approximately 1,200 articles in leading medical journals since its inception. For years, doctors have used a Framingham prediction model to tell who is at high risk for heart disease and who is not.

The Framingham Heart Study made significant findings on blood cholesterol. A strong correlation between high blood cholesterol and heart disease was shown. Researchers noted that men with cholesterol levels “over 244 mg/dL (milligrams per deciliter) have more than three times the incidence of coronary heart disease as do those with cholesterol levels less than 210 mg/dL.”* In the same paper, high blood pressure was also demonstrated to be an important risk factor for heart disease.

This is what you should know: one can work to prevent a heart attack by keeping his or her risk factors at the right levels. Lower risk factors such as blood cholesterol and blood pressure and you lower the risk of heart disease. This knowledge is in large measure due to the scientists and subjects of the Framingham Heart Study. This Study that has spanned generations is still ongoing. It is the most well-known heart study ever done but I am willing to guess that you have never heard about it. Ask yourself why.

Note

* Kannel WB, Dawber TR, Kagan A, et al. “Factors of risk in the development of coronary heart disease – six-year follow up experience.” Ann Internal Medi. 55 (1961): 33-50.

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