Framingham Heart Study: 70 Years Of Groundbreaking Research

FRAMINGHAM, MA—The Framingham Heart Study is celebrating 70 years this month, technically welcoming its first participant on Sept. 28, 1948. With a sign in the city that calls Framingham "the town that changed America's heart," the Study is a large cog in the medical research wheel nationally and started during a time when the country was becoming aware that cardiovascular disease could kill you.

Since it began, the Study has been under the direction of the National Heart, Lung and Blood Institute, following cardiovascular disease development over a period of time that has covered three generations of participants. The original cohort recruited from Framingham included 5,209 men and women between the ages of 30 and 62.

Located next to the Framingham Union Hospital, the Framingham Heart Study building on Lincoln Street has been the home to groundbreaking studies and research that essentially led to the birth of the subspecialty of preventative cardiology.

Vasan Ramachandran, MD, the principal investigator and Boston University Director for the Framingham Heart Study, said Framingham was originally chosen because of its proximity to major hospitals.

"Boston scientists were leading advocates of the study," said Ramachandran. "The [then] town had participated in a Tuberculosis Demonstration Study from 1916-1923, when everyone in town participated. It was an average American community, and people went to one hospital: Cushing Hospital, which no longer exists. There was also not much out migration."

The identification of high blood pressure and high cholesterol at the Framingham Heart Study led to clinical trials of drugs for lowering blood pressure and cholesterol to prevent heart attacks; smoking cessation and optimizing weight to reduce risk of heart attacks and strokes; identification of irregular beating of the heart (disorder called atrial fibrillation) as a risk factor for stroke.

The study has popularized term risk factors, defined the initial set of risk factors for heart disease and stroke, refined those risk factors further. That means this study has described the HDL "good" cholesterol low levels and "bad" LDL levels we've all become familiar with at the doctor's office.

"The study combined these risk factors into a score that can be used to predict who gets heart disease over next 10-years," said Ramachandran, "and identified excess weight as a fundamental precursor of high levels of blood pressure, cholesterol and sugar."

The Framingham Heart Study also introduced cardiac ultrasound for imaging the heart and stress testing on participants in the community to identify forms of subclinical disease, followed up with more sophisticated imaging using CT and MRI techniques; extensive genetic research that includes whole genome sequencing that identifies chromosomal regions that are associated with risk factors, subclinical disease and risk of developing heart attacks, strokes and dementia.

Photo submitted, Framingham Heart Study