Primary prevention of coronary heart disease: Guidance from Framingham: A statement for healthcare professionals from the AHA task force on risk reduction

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  • Grundy, Scott M.
  • Balady, Gary J.
  • Criqui, Michael H.
  • Fletcher, Gerald
  • Greenland, Philip
  • Hiratzka, Loren F.
  • Houston-Miller, Nancy
  • Kris-Etherton, Penny
  • Krumholz, Harlan M.
  • LaRosa, John
  • Ockene, Ira S.
  • Pearson, Thomas A.
  • Reed, James
  • Washington, Reginald
  • Smith, Sidney C., Jr.
    • Affiliation: School of Medicine, Department of Medicine
Abstract
  • The Framingham Heart Study has contributed importantly to understanding of the causes of coronary heart disease (CHD), stroke, and other cardiovascular diseases. Framingham research has helped define the quantitative and additive nature of these causes or, as they are now called, “cardiovascular risk factors.”1 The National Cholesterol Education Program (NCEP)2 3 has made extensive use of Framingham data in developing its strategy for preventing CHD by controlling high cholesterol levels. The NCEP guidelines2 3 adjust the intensity of cholesterol-lowering therapy with absolute risk as determined by summation of risk factors. The National High Blood Pressure Education Program (NHBPEP) has set forth a parallel approach for blood pressure control. In contrast to the NCEP,2 however, earlier NHBPEP reports issued through the Joint National Committee4 did not match the intensity of therapy to absolute risk for CHD. “Normalization” of blood pressure is the essential goal of therapy regardless of risk status. Blood pressure–lowering therapy is carried out as much for prevention of stroke and other cardiovascular complications as for reduction of CHD risk. Nonetheless, risk assessment could be important for making decisions about type and intensity of therapy for hypertension. Thus, the most recent Joint National Committee report5 gives more attention to risk stratification for adjustment of therapy for hypertension. Although Framingham data have already been influential in the development of national guidelines for risk factor management, the opportunity may exist for both cholesterol and blood pressure programs to draw more extensively from Framingham results when formulating improved risk assessment guidelines and recommending more specific strategies for risk factor modification.
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  • Journal Item
Rights statement
  • In Copyright
Journal title
  • Circulation
Journal volume
  • 97
Journal issue
  • 18
Page start
  • 1876
Page end
  • 1887
Language
  • English
Version
  • Postprint
ISSN
  • ‎0009-7322

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