Epidemiological Approaches to Heart Disease: The Framingham Study

Dawber, Thomas R.; Meadors, Gilcin F.; Moore, Felix E.

doi:10.2105/ajph.41.3.279

Cited by 1,823 publications

(1,137 citation statements)

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“…The number of observations (surveys) is 25. This structure resembles the Framingham Heart Study (FHS) data [38]. The simulated values of parameters were taken similar to those obtained in our preliminary analyses of data on diastolic blood pressure for females in the FHS.…”

Section: Simulation Studymentioning

confidence: 93%

Stochastic model for analysis of longitudinal data on aging and mortality

Yashin

Arbeev

Akushevich

et al. 2007

Mathematical Biosciences

133

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Aging-related changes in a human organism follow dynamic regularities, which contribute to the observed age patterns of incidence and mortality curves. An organism's "optimal" (normal) physiological state changes with age, affecting the values of risks of disease and death. The resistance to stresses, as well as adaptive capacity, declines with age. An exposure to improper environment results in persisting deviation of individuals' physiological (and biological) indices from their normal state (due to allostatic adaptation), which, in turn, increases chances of disease and death. Despite numerous studies investigating these effects, there is no conceptual framework, which would allow for putting all these findings together, and analyze longitudinal data taking all these dynamic connections into account. In this paper we suggest such a framework, using a new version of stochastic process model of aging and mortality. Using this model, we elaborated a statistical method for analyses of longitudinal data on aging, health and longevity and tested it using different simulated data sets. The results show that the model may characterize complicated interplay among different components of aging-related changes in humans and that the model parameters are identifiable from the data.

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Section: Simulation Studymentioning

confidence: 93%

Stochastic model for analysis of longitudinal data on aging and mortality

Yashin

Arbeev

Akushevich

et al. 2007

Mathematical Biosciences

133

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show abstract

“…Participant selection criteria and the design of the Framingham Offspring and the Framingham Omni studies have been previously described 21, 22, 23. Offspring Study participants who attended their eighth examination (2005–2008) and Omni Study participants who attended their third examination (2007–2008) underwent a standardized medical history and examination (N=3319), and underwent routine echocardiography (N=3185) with digital image acquisition using a Hewlett‐Packard 5500 machine (Philips Healthcare, Andover, MA).…”

Section: Methodsmentioning

confidence: 99%

Relations Between Aortic Stiffness and Left Ventricular Mechanical Function in the Community

Bell

McCabe

Larson

et al. 2017

JAHA

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BackgroundAortic stiffness impairs optimal ventricular–vascular coupling and left ventricular systolic function, particularly in the long axis. Left ventricular global longitudinal strain (GLS) has recently emerged as a sensitive measure of early cardiac dysfunction. In this study, we investigated the relation between aortic stiffness and GLS in a large community‐based sample.Methods and ResultsIn 2495 participants (age 39–90 years, 57% women) of the Framingham Offspring and Omni cohorts, free of cardiovascular disease, we performed tonometry to measure arterial hemodynamics and echocardiography to assess cardiac function. Aortic stiffness was evaluated as carotid–femoral pulse wave velocity and as characteristic impedance, and GLS was calculated using speckle tracking–based measurements. In multivariable analyses adjusting for age, sex, height, systolic blood pressure, augmentation index, left ventricular structure, and additional cardiovascular risk factors, increased carotid–femoral pulse wave velocity (B±SE: 0.122±0.030% strain per SD, P<0.0001) and characteristic impedance (0.090±0.029, P=0.002) were both associated with worse GLS. We observed effect modification by sex on the relation between characteristic impedance and GLS (P=0.004); in sex‐stratified multivariable analyses, the relation between greater characteristic impedance and worse GLS persisted in women (0.145±0.039, P=0.0003) but not in men (P=0.73).ConclusionsMultiple measures of increased aortic stiffness were cross‐sectionally associated with worse GLS after adjusting for hemodynamic variables. Parallel reductions in left ventricular long axis shortening and proximal aortic longitudinal strain in individuals with a stiffened proximal aorta, from direct mechanical ventricular‐vascular coupling, offers an alternative explanation for the observed relations.

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“…The study design and sampling of the Framingham Offspring Study and the Framingham Omni Study have been described 20, 21, 22. Offspring Study participants who attended examination cycle 8 (2005–2008) and Omni Study participants who attended examination cycle 3 (2007–2008) underwent a standardized medical history and examination (N=3319) and 3185 underwent routine echocardiography with digital image acquisition.…”

Section: Methodsmentioning

confidence: 99%

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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BackgroundThere are few data relating novel measures of left ventricular (LV) mechanical function to cardiovascular disease (CVD) outcomes in the community. Whether distinct components of LV mechanical function provide information regarding risk for different CVD outcomes is unclear.Methods and ResultsWe used speckle tracking echocardiography to quantify distinct components of LV mechanical function (measured as LV strain in multiple planes) in 2831 Framingham Offspring Study participants (mean age, 66 years; 57% women, 97% with LV fractional shortening >0.29). Participants were followed for 6.0±1.2 years for onset of 69 coronary heart disease (CHD), 71 heart failure (HF), and 199 mortality events. Adjusting for CVD risk factors, longitudinal LV strain appeared associated with incident CHD (hazards ratio [HR] per SD increment, 1.29; 95% confidence interval [CI], 1.00–1.67; P=0.05), whereas circumferential and radial strain were not (P>0.37 for both); however, the association of longitudinal strain with CHD was nonsignificant after Bonferroni correction. By contrast, circumferential strain was a significant predictor of incident HF (HR per SD increment, 1.79; 95% CI, 1.35–2.37; P<0.0001). Decrements in circumferential, radial, and longitudinal strain measures were related to all‐cause mortality (P<0.008 for all). Results remained similar in multivariable models adjusting additionally for the conventional echocardiographic measures of LV mass and fractional shortening.ConclusionsIn our large, community‐based sample, distinct components of LV mechanical function were associated with specific CVD outcomes. Additional studies are needed to replicate these findings and investigate the prognostic and therapeutic utility of these novel measures of LV mechanical function.

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Epidemiological Approaches to Heart Disease: The Framingham Study

Cited by 1,823 publications

References 1 publication

Stochastic model for analysis of longitudinal data on aging and mortality

Stochastic model for analysis of longitudinal data on aging and mortality

Relations Between Aortic Stiffness and Left Ventricular Mechanical Function in the Community

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

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