The Framingham Heart Study revolutionized how physicians approach cardiovascular disease (CVD) and placed prevention at the forefront of cardiology.
The study was ahead of its time, producing results that contradicted many prevailing beliefs but were supported by scientific evidence over the past 50 years. William Kannel, M.D., M.P.H., FAHA, received an American Heart Association Distinguished Scientist Award for his work on the study. He began work at the study?s inception and served for 13 years as its director.
Dr. Kannel discussed the insights provided by the study in the Distinguished Scientist Lecture on Monday.
Dr. Kannel mentioned the ?widely recognized? insights of the study but focused on those he believes ?deserve more attention.?
These latter insights have demonstrated the role of multiple risk factors and the importance of modifying any one risk factor. For example, in discussing the risk of increasing age, Dr. Kannel said that individuals who have no other risk factors are much more likely to reach the age of 85 years than individuals who have risk factors. The risk imposed by diabetes is also variable according to the cluster of risk factors. ?We should be paying as much attention to [other] risk factors as to the blood sugar,? Dr. Kannel said.
He said that the Framingham Study showed that, among patients with diabetes, the incidence of stroke, any diabetes endpoint and death were more related to the management of blood pressure than to the management of diabetes.
?Tight control of blood pressure is much more efficacious than tight control of diabetes,? he added.
Another important point from the study is the ?ominous indication? of having decreases in certain CVD risk factors after a myocardial infarction. A spontaneous decrease in systolic blood pressure or cholesterol or unintentional weight loss after an MI are not ?cause for celebration,? he said.
Rather, these decreases were associated with an increased risk of death.
When asked if there was one risk factor that was most important, Dr. Kannel responded, ?There is no single factor that is essential or sufficient to cause the disease,? which proves the point, he added, of multifactorial risk..