Decline in Cardiovascular Mortality: Framingham 1950-1984

2014-08-27 03:57:58 | BioPortfolio


To investigate possible mechanisms responsible for the decline in cardiovascular disease mortality among the Framingham Heart Study population and to evaluate the health status of survivors in terms of subsequent illness and functional limitations.



Cardiovascular disease mortality has declined more than 30 percent in the last thirty years. Almost two-thirds of this decline occurred between 1970 and 1980. Despite this decreased mortality, cardiovascular disease is still the leading cause of death. It is also the disease category associated with the most rapidly rising health care costs. Secular trends in lifestyle, self-care, improved access to medical care, and improvements in diagnostic and curative medicine have all been implicated. An understanding of the mechanisms contributing to this decline is necessary in order to develop a scientific basis for palliative and preventive care. Also, the dramatic decline in cardiovascular disease mortality has raised the issue of the quality of life among the survivors. The question is raised whether more people are surviving but with worsening health in terms of increased incidence and prevalence of disease as well as increased levels of functional limitation.


Five hypotheses were tested to address the issue of secular trends in lifestyle, self-care and medical care which may have influenced cardiovascular disease mortality. These were: differences in risk factor levels among similarly-aged birth cohorts influenced mortality by lessening the severity of disease or by improving recuperative capacity; mortality among the later birth cohorts declined due to less comorbid disease at the time of the disease event; long-term case fatality declined because the progression of disease was slower as evidenced by a reduction in disease recurrence; medical intervention reduced mortality by eliminating lethal sequelae in the later birth cohorts; decreased mortality resulted from medical innovations in diagnosis and therapy. Three hypotheses were tested to address the issue of worsening health among the survivors in the later birth cohorts. These were: although more individuals in the later birth cohorts survived 13 years of follow-up than did members of similarly-aged birth cohorts in earlier periods, they had higher rates of morbidity and were hospitalized more often; survivors in the later cohorts exhibited more disability in functional limitations; more survivors in the later cohorts were institutionalized in chronic care hospitals or skilled nursing facilities. Data on risk factors, co-morbidity, and recurrent cardiovascular disease in the three birth cohorts were already computerized. Data on medical interventions, improvement in case management, and the use of various technological innovations were abstracted from medical records and linked with the data on disease events. Data on functional limitations were available both by type and extent of disability from the Disability Analysis of Health Data, a study supported by the Social Security Administration. This data file was merged with the file for disease events to determine if general differences in functional health existed among the three birth cohorts at intake, and if between-cohort differences existed among survivors.

The study was renewed as a Shannon Award in Fiscal 1991.

Study Design

Observational Model: Natural History


Cardiovascular Diseases




National Heart, Lung, and Blood Institute (NHLBI)

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T03:57:58-0400

Clinical Trials [1284 Associated Clinical Trials listed on BioPortfolio]

Cardiovascular Diseases in HIV-infected Subjects (HIV-HEART Study)

Human immunodeficiency virus (HIV) infection has been associated with a variety of cardiovascular diseases. Even most industrialised countries exhibit a growing and aging population of HIV...

The Effects of Aerobic Exercise in Microvascular Endothelium Function in Patients With Cardiovascular Diseases

This study evaluates the effects of different volumes of aerobic exercise training in cardiovascular parameters of patients with cardiovascular diseases enrolled in a cardiac rehabilitatio...

ARROW:identificAtion of postpRandial biomaRkers tOWards Cardiovascular Prevention

The purpose of this study is to better understand the association between the postprandial biomarker responses after a food challenge with the development of cardiovascular diseases in hea...

Development, Testing, and Validation of A Protocol To Assess Cardiovascular Reactivity in Human Populations

To develop a comprehensive protocol for assessing cardiovascular reactivity to stressors, for use in epidemiological and clinical investigations of cardiovascular diseases in healthy popul...

Cardiovascular Diseases in the Silesian Region in Poland.

The Silesian Cardiovascular Database is an observational study of all patients hospitalized due to cardiovascular diseases. The date include information on the clinical characteristics, tr...

PubMed Articles [11567 Associated PubMed Articles listed on BioPortfolio]

Introduction and Update on Obesity and Cardiovascular Diseases 2018.

Pharmacological Modulation of Vagal Nerve Activity in Cardiovascular Diseases.

Cardiovascular diseases are life-threatening illnesses with high morbidity and mortality. Suppressed vagal (parasympathetic) activity and increased sympathetic activity are involved in these diseases....

Human Emotions on the Onset of Cardiovascular and Small Vessel Related Diseases.

The aim of the present study was to examine the relation between understanding of emotions and cardiovascular related diseases, namely coronary heart disease, diabetes mellitus and obesity. The unique...

Assessment of the Perceived Relationship Between Healthy Nutrition and Cardiovascular Diseases by the Adult Czech Population.

Cardiovascular diseases constitute one of the main causes of disability and premature death. The basic pathology consists of atherosclerosis. Therefore, influencing risk factors, including nutrition, ...

Endothelial function and dysfunction: impact of metformin.

Cardiovascular and metabolic diseases remain the leading cause of morbidity and mortality worldwide. Endothelial dysfunction is a key player in the initiation and progression of cardiovascular and met...

Medical and Biotech [MESH] Definitions

Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.

Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes.

Diseases of long duration and generally slow progression. The four main types of noncommunicable diseases are CARDIOVASCULAR DISEASES (e.g., heart attacks and stroke), CANCER, chronic respiratory diseases (e.g., CHRONIC OBSTRUCTIVE PULMONARY DISEASE and ASTHMA) and DIABETES MELLITUS.

Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)

Dental care for patients with chronic diseases. These diseases include chronic cardiovascular, endocrinologic, hematologic, immunologic, neoplastic, and renal diseases. The concept does not include dental care for the mentally or physically disabled which is DENTAL CARE FOR DISABLED.

More From BioPortfolio on "Decline in Cardiovascular Mortality: Framingham 1950-1984"

Quick Search


Relevant Topics

Cardiology is a specialty of internal medicine.  Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...

Cardiovascular disease (CVD)
Acute Coronary Syndromes (ACS) Blood Cardiovascular Dialysis Hypertension Stent Stroke Vascular Cardiovascular disease (CVD) includes all the diseases of the heart and circulation including coronary heart disease (angina...

Within medicine, nutrition (the study of food and the effect of its components on the body) has many different roles. Appropriate nutrition can help prevent certain diseases, or treat others. In critically ill patients, artificial feeding by tubes need t...

Searches Linking to this Trial