The Framingham Heart Study has been recognized as one of the landmark achievements in science in the 20th century. It was the first long-term epidemiologic study (a branch of medical science that deals with the incidence, distribution, and control of disease in a population) of its kind, designed originally to determine what factors were related to the epidemic of coronary heart disease (CHD). Many of the associations between classical risk factors (smoking, cholesterol, hypertension) and CHD or stroke were first identified in the Framingham Heart Study.
The Framingham Risk Score
One of the most useful and important contributions of the Framingham Heart Study has been the development of a "risk score" for predicting the likelihood that an individual will develop CHD in the next 10 years. Using levels of cholesterol and blood pressure, as well as information regarding age, diabetes status and smoking status, doctors can predict the absolute risk for developing a heart attack or of dying from heart disease in the next 10 years. The National Cholesterol Education Panel's most recent recommendations define high risk as a 10-year predicted risk of >20 percent, intermediate risk as a predicted risk of 10 percent to 20 percent, and low risk as a predicted risk of <10 percent. All patients with diabetes, and anyone who has already had a myocardial infarction (or heart attack), are considered to be at high risk and in need of intensive cholesterol-lowering therapy.
Calculate Your Framingham Risk Score
It is crucial for patients to understand the major risk factors and the role they play in increasing risk for CHD. Patients must know their numbers (cholesterol and blood pressure levels) and discuss with their doctors how best to assess their risk and to reduce their risk to avoid the substantial burden and loss of life due to heart disease. A good first step is for patients to calculate their own Framingham 10-year risk, and then to see what it would be if they had more favorable values. It should be remembered, however, that the Framingham risk score only predicts risk for the next 10 years. It does not predict events that may occur after 10 years.
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