How the Framingham Heart Study Works


What We've Learned from the Framingham Study

Thanks to the Framingham study, we now know that certain behaviors increase a person's chances of developing CVD. Here are some of the findings that now seem commonplace but no one knew for sure before this study — as well as the date the finding was discovered [source: Framingham Heart Study]:

  • 1960: Cigarette smoking found to increase risk of heart disease.
  • 1961: Cholesterol level, blood pressure and electrocardiogram abnormalities found to increase the risk of heart disease.
  • 1967: Physical activity found to lessen the risk of heart disease while obesity increases the risk of heart disease.
  • 1970: High blood pressure found to increase the risk of stroke.
  • 1970: Atrial fibrillation (irregular heartbeat) found to increase stroke risk 5-fold.
  • 1976: Menopause found to increase the risk of heart disease.

"Much of our appreciation of the pathophysiology of heart disease came from the results of studies from the FHS," writes Dr. Rachel Hajar in the journal Heart Views. "It established the traditional risk factors, such as high blood pressure, diabetes and cigarette smoking for coronary heart disease. Framingham also spearheaded the study of chronic noninfectious diseases in the USA and introduced preventive medicine."

These findings led to a public health change from waiting for CVD symptoms to appear to trying to prevent them altogether. As a result, the Framingham Risk Score (FRS) — also known as the clinical risk score — was developed. Physicians continue to use them today to calculate a patient's risk of having or developing cardiovascular disease within 10 years. Each risk category has points assigned to it, which helps physicians calculate the risk specific to men and women. These categories include age, smoking status, blood pressure (treated vs. not treated), cholesterol level and whether or not the patient is diabetic [source: Davis].

The FHS has also identified other risk factors that, although not as impactful as smoking or diabetes, can nonetheless raise a person's risk for CVD. For example, menopause, as well psychosocial issues, like depression, stress and anxiety, are all linked to heart disease. Sleep apnea is also associated with a higher risk of stroke [sources: Hajar, Zoreh].

In addition to the personal risk of CVD, the study aims to give family members a better idea of their genetic odds. In 2010 researchers produced the first solid evidence that a person is three times more likely to have a stroke if one of their parents had a stroke by the age of 65. That same year, they determined that a patient's odds for having atrial fibrillation increase if they have a first-degree relative who has that condition [source: Hajar].

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