You don’t have to be a doctor to know that obesity, smoking, inactivity, poor diet and high cholesterol all contribute to heart disease. You know all this because of the more than six-decades of research by the Framingham Heart Study.
Life before the Framingham Heart Study
Prior to the Framingham Heart Study, most physicians thought atherosclerosis was inevitable part of growing old. They were taught that high blood pressure was supposed to increase with age, enabling the heart to pump blood through narrowed arteries. Doctors did not believe that modifying certain behaviors could help their patients avoid or reverse the underlying causes of serious heart and vascular conditions. They thought heart disease was just something that happened and that there was little they could do to prevent it.
It was in this medical climate that health practitioners in the 1930s and ‘40s witnessed a mounting epidemic of cardiovascular disease. With the death of President Franklin Roosevelt on April 12, 1945, came the wake-up call that eventually led to the study. On the day he died, Roosevelt's blood pressure was measured at an astounding 300/190 and no one had a clue about its relevance.
Committed to undertaking a large-scale investigation into the cause of the sudden rise in cardiovascular death and disability, the U.S. Public Health Institute settled on a novel epidemiological approach designed to learn how and why those who developed heart disease differed from those who did not.
Enter the Framingham Heart Study. In 1948 the Public Health Institute chose Framingham, Massachusetts for this initiative because it was the site of a successful tuberculosis study in 1918 and because it of its proximity to Boston‘s medical centers. Transferred to the National Heart Institute, now the National Heart, Lung, and Blood Institute (NHLBI) in 1949, the study later became affiliated with the Boston University School of Medicine in 1971.
A free physical check-up… and long-term follow-up
The objective of the Framingham Heart Study was to identify the common factors or characteristics that contribute to cardiovascular disease (CVD) by following its development over a long period of time in a large group of participants who had not developed overt symptoms of CVD or suffered a heart attack or stroke.
The initial group was made up of 5,209 men and women between the ages of 30 and 62. Subjects were recruited with a promise of free medical check-ups.
In a 2007 interview with CBS News, Winifred Trumball, one of the very first to commit to the study, said “My husband and I were just married, he had just gotten out of the Army in 1946…in '48, we heard that they were going to have the Framingham Heart Study and you could get a complete physical for nothing. Well, we had no money to go to the doctor, so we couldn't pass that up."
Little did Trumball and her husband know that they, their children, and their grandchildren would become a part of the longest running heart health study in the world.
Since 1948, study participants have returned every two years for a detailed medical history, physical exam and laboratory tests. In 1971, the study enrolled a second generation – 5,124 of the original participants’ adult children and their spouses. In 2002 the Study enrolled the third generation, the original participants’ grandchildren
Ground-breaking research
The research findings of the Framingham Heart Study have truly revolutionized our understanding of CVD. It coined the phrase “risk factor,” and helped to change the way medicine is practiced today by putting emphasis on identifying and assessing risk areas to prevent disease. Its investigations established the link between high levels of cholesterol and high blood pressure and the risk for CVD. The Study was the first to link a lifestyle that included a poor diet, sedentary living, and/or obesity to heart disease. It clearly demonstrated that smokers were at an increased risk for heart attack.
In the past half century, the Study has produced approximately 1,200 articles in leading medical journals. The concept of CVD risk factors has become an integral part of the modern medical curriculum and led to effective preventative practices that have become the standard for good care.
And there is still much to be done. Current research is focused physical traits and genetic patterns. In addition, the Study’s research findings extend beyond heart health and have implications for researchers in the areas of diabetes, dementia, osteoporosis and arthritis, eye diseases, and hearing disorders.
Perhaps the greatest contribution of the Study is that it raised public awareness of the risk factors affecting cardiovascular health.
Writing in the report marking the 50th anniversary of the founding of the heart study, the late Dr. William B. Kannel, former director and principal investigator, said, “We were able to tell people ‘Your life is in your own hands. You can personally reduce your risk of a heart attack.’ "
Contact the Framingham Heart Study offices at 800-854-7582.
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