People from all parts of the world have heard of small town of Framingham, Massachusetts, population 65,000. I recently competed in the 111th running of the Boston Marathon and passed through on my way to Boston from Hopkinton. The 10 kilometer checkpoint on the fabled Boston course is located in Framingham. But that is hardly not the only reason this town is so well known.

According to the American Heart Association, with the exception of 1918, cardiovascular disease has been the leading cause of death in the United States since 1900. Prior to 1940, coronary artery disease was thought to be just a part of the normal aging process that could not be slowed or affected by lifestyle. In those days there was no established relationship between heart disease and cholesterol, diet, smoking, or obesity. Doctors believed that blood pressure was something that was supposed to increase with age. Although people knew about heart disease in 1940, there was certainly no warning that it would reach epidemic proportions by the late 1960s.

Recognizing that heart disease was becoming a major public health concern, in 1948 the National Health Institute went to the town of Framingham and recruited 5,209 healthy residents between the ages of 30 and 62 years to participate in a study. The idea was to monitor the health of these people over the years, see who develops heart disease, and then try to find out why. Every 2 years the Framingham volunteers were given extensive physical exams, lab work ups, and lifestyle interviews. In 1971, a second generation of 5,124 of the original participants adult children and spouses were added to the database.

Now, more 50 years later, the Framingham Heart Study is one of the most recognized in the history of modern medicine. It was through the follow-up work on the residence of Framingham that researchers were able to positively identify the major cardiovascular risk factors that we know so well today such as high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity.

Using the data collected from Framingham, scientists and doctors have published more than 1,000 scientific articles in medical journals and still continue to do so today. New potential risk factors have been discovered and are currently being studied such as the amino acid homocysteine and a lipoprotein called Lp(a). Viral or bacterial infections are being investigated as a potential explanation for early damage to blood vessel walls.

In addition to heart disease, the Framingham data is also being used to study other age-related problems such as stroke, dementia, osteoporosis, arthritis, diabetes, eye disease, and cancer. Armed with DNA from 2 generations of Framingham residents, genetic links to certain diseases are now being explored.

The original Framingham Heart Study paved the way for the prevention revolution in medicine. So next time your doctor tells you to give up smoking, eat a low fat diet, lose weight, or get some exercise, just remember the residents of Framingham who have served as guinea pigs since 1948 to prove that you can do something about your own health.