It is proposed that 3 Framingham Study Monographs be updated using 30-year follow-up data: 1) Section 29: Dealing with age and secular trends in cardiovascular risk factors and their correlation. 2) Section 30: Dealing with the relation of risk factors to development of all the major fatal and non-fatal cardiovascular events by age and sex and their net effects judged from multivariate regression coefficients. 3) Section 32: Dealing with cardiovascular disease and death following myocardial infarction and angina pectoris and the relation of standard cardiovascular risk factors to this prognosis. The prior versions of these Framingham monographs were based on 18 years of follow-up. They have been a useful source of data which can be found in almost every medical library and department of epidemiology, preventive medicine and biostatistics. The NHLBI is no longer planning to compile and publish these monographs. An update is important and needed for a number of reasons including the following: Section 32 on prognosis following onset of clinical coronary heart disease was based on a scant number of new events and short follow-up. This information on natural history is sorely needed as a standard of comparsion for drug trials and surgery since placebo-controlled trials are becoming more difficult to implement. Update of Section 30 will provide risk factor information for cardiovascular events occurring in the geriatric 65-84 year old age group and for women where previous information was scanty. More information will be provided on less common cardiovascular events such as sudden death; unstable angina, atrial fibrillation and the like. Additional follow-up will provide more substantial populations at risk with uncommon risk factors such as intraventricular conduction disturbances, glycosuria, various arrythmias etc. Extension of Section 29 will provide data on trends in cardiovascular risk factors as people actually age under continuous biennial observation extendint into the geriatric ages of 65-90 years. An update will also allow an examination of secular trends extending over a time period when cardiovascular mortality rates have been declining dramatically. By examining the inter-relationships among risk factors we can provide some insights into their determinants. Alternative statistical aproaches to analysis of longitudinal risk factor information in predicting cardiovascular disease will be applied.
| Wolf, P A; D'Agostino, R B; Kannel, W B et al. (1988) Cigarette smoking as a risk factor for stroke. The Framingham Study. JAMA 259:1025-9 |
| Kannel, W B (1987) Status of risk factors and their consideration in antihypertensive therapy. Am J Cardiol 59:80A-90A |
