Sequester cuts threaten Framingham Heart Study

Boston University officials say the Framingham Heart Study, which studies health hazards associated with smoking, is being hurt by federal spending cuts. The cuts, commonly known as the sequester, will reduce federal spending by $4 million on the 65-year-old study, which began when tobacco advertising routinely featured doctors promoting cigarette smoking. Study officials said 19 staff of 90 staff members would lose their jobs this fall and certain ancillary studies would be eliminated, the Huffington Post reported. "You're going to lose a major investment that we've been making over the last 65 years," said Dr. Karen Antman, dean of Boston University School of Medicine, which co-runs the Framingham Heart Study. "This is an iconic trial that has more than proven its value from a public health point of view ... It's made an enormous difference by identifying diabetes, hypertension, hyperlipidemia and other risk factors," Antman said. "We've really decreased deaths from cardiovascular disease. That human laboratory would be lost." Before the Framingham Heart Study, cardioligists mostly studied congenital heart disease, rheumatic or valvular heart disease or aortic regurgitation caused by tertiary syphilis. In 1947, epidemiological knowledge of coronary heart disease was spotty and morbidity incidence and prevalence rates from unbiased samples were almost non-existent, the American Journal of Public Health said. By 1948, 44 percent of U.S. deaths could be attributed to cardiovascular disease, a 20 percent increase since 1940, but the causes of cardiovascular disease were poorly understood, the journal said. In 1948, the Framingham Heart Study -- under the direction of the National Heart Institute, now known as the National Heart, Lung and Blood Institute, and Boston University -- began recruiting 5,209 men and women ages 30-62 from the town of Framingham and began the first round of extensive physical examinations, lifestyle interviews and tests that would be repeated every two years. In 1971, the study enrolled a second generation of 5,124 study subjects -- adult children of the original participants and their spouses -- to participate in similar examinations. In 1994, the first Omni cohort of the Framingham Heart Study was enrolled with a more diverse community. In April 2002, the study enrolled a third generation of participants, the grandchildren of the original study subjects and in 2003, a second group of Omni participants was enrolled. The Framingham Heart Study attained iconic status, both as the prototype of the cohort study -- a long-term study that tracks a group of people who do not have a disease and uses correlations to determine risk factors -- and as a result of its scientific success, the American Journal of Public Health said. In constructing their investigation, Framingham's initiators had to invent new approaches to epidemiological research. The fact that Framingham tracked its subjects for half a century allowed investigation of a spectrum of diseases, including those of old age, the journal said. In the past half century, the study produced approximately 1,200 articles in leading medical journals. However, for cohort studies to be effective, continuity is required and massive amounts of medical information must be updated and maintained. A loss of funding makes this problematic, Antman said. Framingham compiles tissue banks and blood samples, conducts psychological tests and physical exams, and performs magnetic resonance imaging and heart echoes, among other tests. All of this is done for the purpose of connecting the dots between biological and physiological variables and cardiovascular diseases, Antman said.