Saturday, December 06, 2008

If I'd only been born here...

A Change of Heart: How the People of Framingham, Massachusetts, Helped Unravel the Mysteries of Cardiovascular Disease
by Daniel Levy, M.D., and Susan Brink

Framingham is legendary in medical and anthropological circles. They started tracking the medial stories of 5000 locals in 1948, taking physicals every 2 years. This has allowed them to monitor the progression of all sorts of diseases including hypertension, atherosclerosis, cancer, strokes, etc., and to see the relationship between physical conditions and the resulting afflictions.

About 60 years ago, the worlds views on medicine were drastically different than they are today. Blood pressure was thought to be healthy when naturally rising with age. Diets were thought to be healthy when including MEAT MEAT FAT MEAT. Smoking was HEALTHY.

When FDR died, his blood pressure was something like 300/180. In today's world, that's absurd. It means his arteries were all so hardened that his heart was working ridiculously hard to create any sort of circulation. It killed him. A normal, healthy pressure is about 120/60.

Through Framingham, they recognized the relationship between high blood pressure and heart attacks, strokes, etc. They recognized the general existence of risk factors (and coined the phrase). They fought to educate physicians around the world to treat their patients, helped spur the development of statins, and changed overall perspectives on medicine.

As the original Framingham 5000 aged, a second group was added to the study - their descendents. They're now on to the third generation. People have moved away, but come back every two years for their 2 days of extensive tests, because they have recognized their responsibility to the study and all the good it's done.

The funding for the original study ran out in 1978, and it was almost ended. Thankfully, through university partnerships and a LOT of fighting for funding, it still survives. They publish probably hundreds of studies each year, generally either groundbreaking or confirming unproven theories, simply because they have access to so much data. The study started in the era of room-sized computers requiring punch cards. Even then the doctors and scientists managed to capture massive amounts of data from each patient that allowed trending. Now, they can capture even more, and the data crunching takes significantly less time.

The book is written by one of the directors of the study, providing an interesting insider's view. Having read tons of journal articles originating from them, it was great to see all the stories and people behind it.

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posted by ket at 12:39 PM


Blogger reyn said...

How cool would it be if we could expand the scope of the study even further? A nationwide database of health indicators, tied in to your annual checkup! I mean, we'd have to start HAVING annual checkups (I think my last annual checkup happened when I was eight), and there are obvious civil rights concerns, but it's fun to consider.

...I thought 120/80 was healthy? 300/180 doesn't even sound possible.

12/08/2008 1:27 PM  

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