Framingham Heart Study - Framingham

Description:

Long-term observational study of atherosclerotic disease.

Hypothesis:

Whether optimal risk predictions can be obtained from a quantitative synthesis of risk factors into a composite estimate.

Study Design

Female: 0

Patient Populations:

Not given

Exclusions:

Not given

Primary Endpoints:

Mortality, cardiovascular disease

Secondary Endpoints:

not given

Drug/Procedures Used:

Not given

Concomitant Medications:

Not given

Principal Findings:

Net impact of specified risk factors on cardiovascular outcomes (increment per standard deviation increase, %) coronary disease, blood pressure:
Systolic (men 33% [p<0.001]; women="" 42%="">
Diastolic (men 33% [p<0.001]; women="" 34%="">

Coronary disease, serum cholesterol (men 34% [p<0.001]; women="" 30%="">
Coronary disease, hematocrit (men 0.6% [nonsignificant]; women 8% [p
Coronary disease, glucose (men 4% [nonsignificant]; women 18% [p
Coronary disease, Met. relative weight (men 16% [p<0.001]; women="" 15%="">
Coronary disease, vital capacity (men -3% [nonsignificant]; women -26% [p
Coronary disease, heart rate (men 5% [nonsignificant]; women -3% [nonsignificant])
Coronary disease, cigarettes (men 34% [p<0.001]; women="" 15%="">

Stroke, blood pressure:
Systolic (men 63% [p<0.001]; women="" 49%="">
Diastolic (men 69% [p<0.001]; women="" 50%="">

Stroke, serum cholesterol (men -1% [nonsignificant]; women -4% [nonsignificant])
Stroke, hematocrit (men 39%[p<0.001]); women="" 15%="">
Stroke, glucose (men 4% [nonsignificant]; women 14% [p
Stroke, Met. relative weight (men 6% [nonsignificant]; women 8% [nonsignificant])
Stroke, vital capacity (men -7% [nonsignificant]; women -28% [p
Stroke, heart rate (men 14% [nonsignificant]; women 7% [nonsignificant])
Stroke, cigarettes (men 38% [p<0.001]; women="" 10%="">

Peripheral vascular disease, blood pressure:
Systolic (men 33% [p<0.001]; women="" 40%="">
Diastolic (men 17% [nonsignificant]; women 24% [p

Peripheral vascular disease, serum cholesterol (men 29% [p<0.01]; women="" 25%="">
Peripheral vascular disease, hematocrit (men 26%[p<0.001]); women="" -1%="">
Peripheral vascular disease, glucose (men 22% [p<0.001]; women="" 29%="">
Peripheral vascular disease, Met. relative weight (men 30% [p<0.001]; women="" 1%="">
Peripheral vascular disease, vital capacity (men -19% [nonsignificant]; women -3% [nonsignificant])
Peripheral vascular disease, heart rate (men 12% [nonsignificant]; women 5% [nonsignificant])
Peripheral vascular disease, cigarettes (men 61% [p<0.001]; women="" 53%="">

Congestive heart failure, blood pressure:
Systolic (men 28% [p<0.01]; women="" 37%="">
Diastolic (men 12% [insignificant]; women 34% [p

Congestive heart failure, serum cholesterol (men 25% [p<0.05]; women="" -4%="">
Congestive heart failure, hematocrit (men 9%[nonsignificant]; women 36% [p
Congestive heart failure, glucose (men 29% [p<0.001]; women="" 25%="">
Congestive heart failure, Met. relative weight (men -% [nonsignificant]; women 38% [p
Congestive heart failure, vital capacity (men -48%; women 100% [p
Congestive heart failure, heart rate (men 42% [p<0.001]; women="" 13%="">
Congestive heart failure, cigarettes (men 30% [p<0.001]; women="" 15%="" [nonsignificant])="" women="" 15%="">

Interpretation:

The Framingham study has established innumerable landmarks for evidence-based cardiology. Acceptable values for blood pressure, cholesterol and glucose have been revised downward, smoking rendered unacceptable, exercise promoted and eating habits revised. The use of risk profiles makes it possible to regard the onset of overt coronary heart disease as a preventive failure rather than as the first indication for treatment.

References:

1. Ann Intern Med 1991;115:687-93. MI risk factors
2. J Am Coll Cardiol 1993;22(Supp A):6A-13A. Heart failure
3. Cardiology 1993;82:137-152. Composite risk factors
4. Am Heart J 1996; 131:790-5. Atrial fibrillation
5. JAMA 1996; 275:1571-6. Hypertension risk factors
6. JAMA 1996; 276:1269-78. Stroke risk factors
7. Am Heart J 1996; 132:174-8. Angina pectoris

Clinical Topics: Dyslipidemia, Heart Failure and Cardiomyopathies, Vascular Medicine, Atherosclerotic Disease (CAD/PAD), Lipid Metabolism, Nonstatins, Acute Heart Failure

Keywords: Hematocrit, Cholesterol, Stroke, Heart Failure, Risk Factors, Blood Pressure, Heart Rate, Peripheral Vascular Diseases, Glucose, Vital Capacity


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