Framingham Heart Study (FHS)

What is the goal of the FHS?

The NHLBI has a long history of 

supporting large population and epidemiology studies 

that have transformed the way the public approaches heart disease. 

These studies involve studying 

the health of various populations 

to uncover patterns, trends, and 

outcomes that may be applicable to the general population. 

When it launched in 1948 

the original goal of the Framingham Heart Study (FHS) was 

to identify common factors or characteristics 

that contribute to cardiovascular disease. 

Over the years, 

the FHS has become a successful, 

multigenerational study that 

analyzes family patterns of cardiovascular and other diseases, 

while gathering more genetic information 

from the two generations that

 followed the original study participants. 

The FHS also has expanded 

to include diverse populations 

so that risk factors in these different groups 

can be understood.

AT A GLANCE

The FHS had over 14,000 people from three generations, 

including the original participants, 

their children, and their grandchildren.

FHS findings have informed the understanding of 

how cardiovascular health affects the rest of the body.

The study found high blood pressure and 

high blood cholesterol to 

be major risk factors for cardiovascular disease.

In the past half century, 

the study has produced approximately 3,000 articles 

in leading medical journals.

Data resources from the study are available 

for researchers to use, 

and those data continue to spur new scientific discoveries.

What are the key findings of the FHS?

This research has contributed transformative discoveries 

related to the treatment of heart disease. 

Through the FHS, 

scientists have learned 

the risk factors for heart disease, 

and they now know that 

many of those risks can be changed. 

It is why, in routine physicals, 

doctors check for high blood pressure, 

high cholesterol, 

unhealthy eating patterns, 

smoking, physical inactivity, or 

unhealthy weight. 

Researchers also know that 

these conditions can affect people 

differently depending on a patient’s sex or race. 

Findings such as these 

pave the way for new interventions 

to preempt, prevent, or

 treat these conditions more effectively.

In the past half century, 

the study has produced approximately 3,000 articles

 in leading medical journals. 

Here are a few of the major findings from the FHS:

• 1960s: Cigarette smoking was found
  to increase the risk of heart disease, and cholesterol level,
  blood pressure, and electrocardiogram abnormalities
  were found to increase the risk of heart disease.

• 1970s: High blood pressure was found to increase the risk of stroke;
  atrial fibrillation was found to increase stroke risk five-fold;
  and menopause was found to increase the risk of heart disease.

• 1980s: High levels of HDL cholesterol were found to reduce risk of death.

• 1990s: An enlarged left ventricle, one of two lower chambers of the heart,
  was shown to increase the risk of stroke.

• 2000s: Prehypertension was associated with
  an increased risk of cardiovascular disease,
  emphasizing the need to determine
  whether lowering high-normal blood pressure
  can reduce the risk of cardiovascular disease

• 2010s: Sleep apnea was tied to an increased risk of stroke;
  FHS researchers identified additional genes
  that may play a role in Alzheimer's disease;
  study investigators discovered hundreds of genes
  underlying major heart disease risk factors.

Since its early days,
the FHS has been committed to data sharing.
In 1968,
the FHS made massive data tables
of FHS-collected measures freely available
to outside researchers,
many of whom lacked computing resources.

NHLBI has continued to leverage FHS resources
to spur new scientific discovery through data sharing.

The NHLBI is using FHS data
in the TOPMed Program
to better understand the genetic and environmental factors
contributing to cardiovascular disease.

Study datasets from the FHS,
including cohort examination data
from the first 30 clinical exams,
are available for request
via NHLBI’s Biologic Specimen and
Data Repositories Information Coordinating Center (BioLINCC). 

Researchers also can request FHS genetic data,
along with information about major disease risk factors
(e.g., systolic blood pressure, cholesterol levels, cigarette use),
in the database of Genotypes and Phenotypes (dbGaP). 

How is the FHS conducted?

When the FHS began in 1948, 

researchers recruited 5,209 men and women

 between the ages of 30 and 62 

from the town of Framingham, Massachusetts. 

This was for the first round of extensive physical examinations 

and lifestyle interviews 

they would later analyze for common patterns 

related to cardiovascular disease development. 

Since then, 

the participants have continued to return 

to the study approximately every two to six years 

to give researchers a detailed medical history and 

to get physical exams and laboratory tests done. 

In 1971, 

the study enrolled a second generation

—5,124 of the original participants' adult children and 

their spouses

—to participate in similar examinations. 

In April 2002, 

the study entered a new phase: 

the enrollment of a third generation of participants, 

the grandchildren of the original cohort.

Researchers recognized 

the need to establish a new study 

reflecting Framingham’s more diverse communities. 

In 1994 

they enrolled the first 

Omni Cohort of the Framingham Heart Study

—507 men and women of African-American, 

Hispanic, Asian, Indian,

 Pacific Islander, and 

Native American descent. 

In 2003, a second group of Omni 

participants was enrolled.