Epidemiological Background and Design: the Framingham Study

The Framingham Heart Study is widely acknowledged as a premier longitudinal study. Several historical reviews of its background and design already exist (Dawber, 1980; Dawber, Kannel and Lyell, 1963; Dawber, Meadors and Moore, 1951; Dawber and Moore, 1952; Dawber, Moore and Mann, 1957; Feinlieb, 1983; Gordon and Kannel, 1968a; Gordon and Kannel, 1972 and Higgins, 1984). These were often written by the original investigators or those close to the origins of the study. They present the background facts and clarify the chronology. They give the warriors' statements of their battles or they give an informative and authoritative backdrop for understanding the scope and limitations of the study. In many ways little can be added. Nevertheless, we now proceed to present another history. We will attempt to satisfy the objectives of the previous histories. We will review the historical background and needs that gave rise to the study. We will also review the various components and stages, both chronological and conceptual, that ultimately resulted in this widely quoted study. These will be done not only in a chronological fashion detailing the study as it historically evolved, but also in a retrospective manner taking advantage of the insights which retrospective review can furnish. This latter perspective may be unique from some of the previous reviews. Finally, we will attempt to give a history sufficient to supply the correct context for the other papers in this session.