Worcester Business Journal

8 Worcester Business Journal | April 29, 2019 | wbjournal.com Changing the health of a With $38M more in funding, the Framingham Heart Study eyes a fourth generation of research BY GRANT WELKER Worcester Business Journal News Editor GENERATION M ore than seven decades ago, about two-thirds of Framingham's adult population signed up for a first-of-its-kind medical study. More than 5,000 of them would be tracked for cardiovascular health over a long course of time. ose participants couldn't have known just how long the Framingham Heart Study would last or how impact- ful doctors' findings would become. By 1960, doctors at the program would determine smoking was a heart disease risk, a finding that came four years before the landmark U.S. Surgeon General's ruling requiring cigarettes to come with clear health warnings. Findings in the '60s included risks of obesity and benefits of exercise. Later, doctors found connections between high blood pressure and higher stroke risks and between good cholesterol and lower risks of premature death. Now, the Framingham Heart Study is getting an extension to allow it to con- 1957: High blood pressure and high cholesterol levels shown to increase likelihood of heart disease 1959: Some heart attacks discovered to be silent, or causing no pain 1960: Cigarette smoking found to increase the 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 reduce the risk of heart disease and obesity to increase the risk of heart disease 1970: High blood pressure found to increase the risk of stroke 1970: Atrial fibrillation increases stroke risk fivefold 1976: Menopause found to increase the risk of heart disease 1978: Psychosocial factors found to affect heart disease 1994: Enlarged left ventricle (one of two lower chambers of the heart) shown to increase the risk of stroke 1996: Progression from hypertension to heart failure described 2001: High-normal blood pressure is associated with an increased risk of cardiovascular disease 2002: Obesity is a risk factor for heart failure 2009: Parental dementia may lead to poor memory in middle-aged adults 2009: High leptin levels may protect against Alzheimer's disease and dementia 2010: Sleep apnea tied to increased risk of stroke 2010: Additional genes identified that may play a role in Alzheimer's 2010: Fat around the abdomen associated with smaller, older brains in middle-aged adults 2012: Higher vascular stiffness is a precursor, instead of the result of, hypertension in middle-aged adults 2018: Former smokers who quit smoking 25 or more years ago still have three times as much risk of developing lung cancer compared to people who have never smoked Key findings from the Framingham Heart Study Source: Framingham Heart Study tinue to monitor thousands of partici- pants and look for potentially troubling new signs. e National Heart, Lung and Blood Institute said in April it is extending the contract for another six years, including $38 million in funding. e extension allows the study to begin examining older participants for signs of aging by looking at liver fat, platelet function, arterial stiffness and other factors. at extension is critical for con- tinued research, doctors there said. "We have generated more data in these past two years than in the first 68 years," said Dr. Daniel Levy, the study's director for more than three decades. Starting with $500K e study has become a trove of vital information for cardiovascular experts far beyond Framingham. Researchers across the world have applied for access to the study's information, Levy said. e American Heart Association marked the study's 70th anniversary last year by calling the Framingham Heart Study "the study and the town that changed the health of a generation." "It's a landmark study," Levy said. "It's a national treasure." Little was known about heart disease and other cardiovascular issues in the 1940s. So little was known, in fact, when President Franklin D. Roosevelt died in 1945 with severely high blood pressure, little could have been done to improve his health because no medication existed yet to lower blood pressure, Levy said. At the time, Levy said, the leading causes of death were related to infectious disease. Now it's heart disease. More than 600,000 Americans died of heart disease in 2016, according to the Centers for Disease Control & Prevention. e study began in 1948 with a $500,000 federal grant for heart disease research, with Framingham ultimately chosen because of its proximity to major research in Boston and its typical-Amer- ica demographics, according to a book on the study by Dr. Benjamin Yang. Early exams included typical looks at blood pressure, height, weight and lung function, and participants were asked about eating, sleeping and smoking hab- its, according to Yang. Detailed partici- pants' dieting histories weren't included until the fourth round of testing. Today, the study has bone density tests and brain, heart and abdomen MRIs. All those test results have produced enough information to be cited in nearly 3,700 published journal articles, accord- Dr. Daniel Levy, Framingham Heart Study director ing to the American Heart Association. Findings include not only heart health but dementia and Alzheimer's disease. Four generations of participants If the study could seem inconvenient or even intrusive, that's not how partic- ipants tend to see it. More than 15,000 have taken part at some point. "I've never heard anyone say they thought it was inconvenient. ey look forward to going," said Dennis Gi- ombetti, the chair of the Framingham Researchers at the Framingham Heart Study now are working on studying data from the second and third generations of descendants from the original group of participants. PHOTO/COURTESY

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