The DOI matches its Crossref record; 85 of the 86 references it cites were found in a registry or an index; none of the 83 sources its claims cite is checked for support yet.
The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective
Open accessAbstract
Summary On October 11, 2013, the Framingham Heart Study will celebrate 65 years since the examination of its first participant in 1948. During this period, the study has provided substantial insight into the epidemiology of cardiovascular disease and its risk factors. The origin of the study is closely linked to the cardiovascular health of President Franklin D. Roosevelt and his premature death from hypertensive heart disease and stroke in 1945. The present article describes the events leading to the founding of the Framingham Heart Study, and provides a brief historical overview of selected contributions from the study.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
71 Not checked yet · 6 Own interpretation · 2 Own result · 2 No basis given · 1 Own method
In the paper
“In 1971, Framingham investigators analyzed 14 years of follow-up data to demonstrate increased risk of coronary heart disease morbidity with rising baseline blood pressure.42”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Epidemiological activism
What the sources say
- Not checked yetcites [42] Finenberg, 1927, Systolic hypertension. Its relationship to atherosclerosis of the aorta and larger arteries, Am J Med Sci source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A few years later they noted that stroke was also a major consequence of high blood pressure.27”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Early days of Framingham
What the sources say
- Not checked yetcites [27] Kannel, 1961, Factors of risk in the development of coronary heart disease—six year follow-up experience, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“By the end of the 8th Framingham examination cycle in 1966, investigators had noted a rising prevalence of heart failure in the cohort.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Individuals in the top decile compared with the lowest decile had a thirty-fold (men) to seventy-fold (women) difference in the incidence of coronary heart disease.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham Risk Scores
What the sources say
- Not checked yetcites [48] Staessen, 1997, Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension, Lancet source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Women comprised more than half of all participants.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Early days of Framingham
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When systolic and diastolic pressures were studied for association with coronary heart disease events, systolic pressure demonstrated a stronger link than diastolic pressure (Figure 4).”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Epidemiological activism
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Indeed, the term “risk factor” was popularized in the medical lexicon by Thomas Dawber and William Kannel by their 1961 publication, “Factors of Risk in the Development of Coronary Heart Disease.”25”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham Risk Scores
What the sources say
- Not checked yetcites [25] Keys, 1989, Longevity of man: relative weight and fatness in middle age, Ann Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The 10-year risk estimates used in the 1998 score provided a convenient way to classify individuals as low, intermediate, or high risk for future coronary heart disease.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham Risk Scores
What the sources say
- Not checked yetcites [50] Kannel, 1976, A general cardiovascular risk profile: the Framingham study, Am J Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Until the late 1960s, research on heart failure was hampered by a lack of consistent diagnostic criteria.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [52] 2002
- Not checked yetcites [53] Gibson, 1966, The prevalence of congestive heart failure in two rural communities, J Chronic Dis source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The Committee still recommended diastolic blood pressure as the basis for diagnosis and treatment of hypertension, but over the next decade, the emphasis on diastolic blood pressure as the principal treatment target was dropped after randomized controlled trials demonstrated the cardiovascular benefits of systolic blood pressure reduction.46,47”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Epidemiological activism
What the sources say
- Not checked yetcites [45] Kannel, 1972, Role of blood pressure in the development of congestive heart failure. The Framingham study, N Engl J Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 21
- Probably not a substantial claim. 11
In the paper
“The original cohort was recruited between 1948 and 1952 and consisted of 5209 residents aged 28 to 62 years (Table 1).25”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Early days of Framingham
What the sources say
- Not checked yetcites [25] Keys, 1989, Longevity of man: relative weight and fatness in middle age, Ann Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The first major study findings were published in 1957, almost a decade after the initial participant was examined. Defining hypertension as a systolic blood pressure ≥160/95 mmHg, they found a nearly 4 fold increase in coronary heart disease incidence per 1000 persons among hypertensive participants.26”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Early days of Framingham
What the sources say
- Not checked yetcites [26] Oppenheimer, 2006, Profiling risk: the emergence of coronary heart disease epidemiology in the United States (1947–70), Int J Epidemiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In two other studies, investigators found that elevated systolic blood pressure was a predictor of cerebrovascular accidents as well as heart failure, and that diastolic pressure was not superiorly associated with these events. 43,44”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Epidemiological activism
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“On the other hand, hypertension was associated with a >2 fold increased risk of heart failure, but had a PAR of 59% (women) and 39% (men) owing to its high prevalence.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [57] McKee, 1971, The natural history of congestive heart failure: the Framingham study, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Examining 16 years of observational data, the investigators found that hypertension preceded three-quarters of heart failure cases, compared with coronary artery disease, which preceded heart failure in less than 40% of cases.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [56] McNamara, 1967
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Myocardial infarction was associated with a 6-fold risk for heart failure, but the PAR was only 13% (women) and 34% (men).”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [57] McKee, 1971, The natural history of congestive heart failure: the Framingham study, N Engl J Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“On June 16, 1948, President Harry Truman signed into law the ‘National Heart Act.’”
- Also stated in: § Origins of the Framingham Heart Study · plain
“The law allocated a $500,000 seed grant for a twenty-year epidemiological heart study, and also established the National Heart Institute, which today is known as the National Heart, Lung and Blood Institute.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Origins of the Framingham Heart Study
What the sources say
- Not checked yetcites [11] Bernstein, 1976, The uneasy alliance: Roosevelt, Churchill, and the atomic bomb, 1940–1945, West Polit Q source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Origins of the Framingham Heart Study · plain
In the paper
“Nine ‘major’ criteria and seven ‘minor’ criteria were defined, along with one criterion that could be major or minor depending on whether the ≥4·5 Kg weight loss was due to heart failure treatment or from another possible etiology. A diagnosis of ‘Definite heart failure’ was made if the patient had two major, or one major plus two minor criteria concurrently.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [56] McNamara, 1967
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“The young cardiologist gave the President his first diagnosis of “hypertension, hypertensive heart disease, and cardiac failure.”5”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Origins of the Framingham Heart Study
What the sources say
- Not checked yetcites [5] Bruenn, 1970, Clinical notes on the illness and death of President Franklin D. Roosevelt, Ann Intern Med source
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“President Roosevelt died a few weeks later on April 12, 1945, at the age of 63, from cerebral hemorrhage with a blood pressure of 300/190 mmHg.5”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Origins of the Framingham Heart Study
What the sources say
- Not checked yetcites [5] Bruenn, 1970, Clinical notes on the illness and death of President Franklin D. Roosevelt, Ann Intern Med source
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The state was considered ideal due to the enthusiastic response of area physicians (Figure 2), and Framingham prevailed over neighboring towns due to geographical proximity to the many cardiologists at Harvard Medical School.13”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Choosing a location
What the sources say
- Not checked yetcites [13] Meadors, 1947
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The creation of a family-based cohort was prescient, given the emergence of new genotyping and sequencing technologies a few decades later.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Fight for survival
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The first attempt to create a multivariable risk function for coronary heart disease in Framingham was published by Truett, Cornfield, and Kannel in 1967.48”
- Also stated in: § Framingham Risk Scores · plain
“The authors proposed a multivariable logistic models with 7 risk factors: age, total cholesterol, weight, ECG abnormality, hemoglobin, cigarettes smoked, and systolic blood pressure.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham Risk Scores
What the sources say
- Not checked yetcites [48] Staessen, 1997, Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Framingham Risk Scores · plain
In the paper
“Between 1935 to 1941, the President experienced a gradual rise in blood pressure from 136/78 to 188/105 mm Hg.6 p213”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Origins of the Framingham Heart Study
What the sources say
- Not checked yetcites [6] Bumgarner, 1994
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Compared with previously published functions, the 1998 model substituted risk factor categories in the place of continuous values, which enabled clinicians to use lookup tables to obtain risk estimates.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham Risk Scores
What the sources say
- Not checked yetcites [50] Kannel, 1976, A general cardiovascular risk profile: the Framingham study, Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Framingham investigators initially struggled between whether to be an observational study to understand heart disease, or instead focus on preventing heart disease in the local population. Ultimately, given the paucity of effective interventions, the former approach won favor.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Early days of Framingham
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“By the 1940s, cardiovascular disease had become the number one cause of mortality among Americans, accounting for 1 in 2 deaths.4”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Origins of the Framingham Heart Study
What the sources say
- Not checked yetcites [4] Kannel, 1990, Bishop lecture. Contribution of the Framingham study to preventive cardiology, J Am Coll Cardiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The Committee still recommended diastolic blood pressure as the basis for diagnosis and treatment of hypertension, but over the next decade, the emphasis on diastolic blood pressure as the principal treatment target was dropped after randomized controlled trials demonstrated the cardiovascular benefits of systolic blood pressure reduction.46,47”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Epidemiological activism
What the sources say
- Not checked yetcites [46] Moser, 1977, Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. A cooperative study, JAMA source
- Not checked yetcites [47] 1991, Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP), JAMA source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The PAR for heart failure due to obesity was 14% in women, and 11% in men, higher than that observed for diabetes mellitus, valvular heart disease, or left ventricular hypertrophy.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Metabolic risk factors for heart disease
What the sources say
- Not checked yetcites [78] Hubert, 1983, Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Recent guidelines have a notable emphasis on the detection of asymptomatic ventricular dysfunction (“stage B heart failure”) as part of efforts to understand and prevent overt heart failure.61”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [61] Wang, 2003, Natural history of asymptomatic left ventricular systolic dysfunction in the community, Circulation source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The original 1971 publication highlighted the poor prognosis of heart failure: only 2 in 5 men were alive 5 years after diagnosis the heart failure, and only 1 in 5 survived to 10 years.56”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [56] McNamara, 1967
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“By the late 1970s, when William Castelli became the fourth director of the Framingham Heart Study, the general US population weight had been increasing for several decades.76”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Metabolic risk factors for heart disease
What the sources say
- Not checked yetcites [76] Castelli, 1977, HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein phenotyping study, Circulation source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Ancel Keys described elevated levels of cholesterol among coronary heart disease patients.73”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Metabolic risk factors for heart disease
What the sources say
- Not checked yetcites [73] Anitschkow, 1983, Classics in arteriosclerosis research: on experimental cholesterin steatosis and its significance in the origin of some pathological processes, Arteriosclerosis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The variables in the model mirrored those in the Truett study, except that glucose intolerance was added, and weight was dropped.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham Risk Scores
What the sources say
- Not checked yetcites [49] Truett, 1967, A multivariate analysis of the risk of coronary heart disease in Framingham, J Chronic Dis source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Diabetes was associated with substantially higher risks for heart failure and hypertensive heart disease.69,70”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Metabolic risk factors for heart disease
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Survival of individuals with heart failure with preserved ejection fraction (or diastolic heart failure) was substantially worse compared with individuals without heart failure, though it was better compared with individuals with systolic heart failure.”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Framingham and the epidemiology of heart failure
What the sources say
- Not checked yetcites [62] Hunt, 2005, Circulation source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Cholesterol had been linked to cardiovascular disease by the early 20th century through animal and autopsy studies.71,72”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Metabolic risk factors for heart disease
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Critics of Framingham expressed uncertainty about whether study participants represented Americans in general and about the study's family-based approach.33”
§ The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective > Early days of Framingham
What the sources say
- Not checked yetcites [33] Caird, 1963, Heart disease in old age, Postgrad Med J source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
By the 1990s, widespread use of beta-blockers and ACE inhibitors altered the prognosis of heart failure.
“By the 1990s, the widespread use of mortality-altering medications such as beta-blockers and ACE inhibitors had altered this prognosis.”
The paper relies on this without support.
Diastolic heart failure is common in the community, particularly among older individuals and women.
“Studies from other cohorts yielded consistent findings, and led to increased recognition that diastolic heart failure is common in the community, particularly among older individuals and women.”
The paper relies on this without support.
Obesity co-occurs with hypertension, elevated lipids, and diabetes, and increased cardiovascular risk in obese individuals is often attributed to these co-existing risk factors.
“As obesity occurs concomitantly with hypertension, elevated lipids, and diabetes, the increased cardiovascular risk in obese individuals is often attributed to these co-existing risk factors.”
The paper relies on this without support.
Each suspected new case of stroke in Framingham was confirmed by a second examiner and through neurological consultation.
“Each suspected new case of stroke was confirmed by a second examiner as well as through neurological consultation.”
The paper relies on this without support.
Anticoagulation for individuals with atrial fibrillation became the standard of care.
“Fortunately, such trials were performed and anticoagulation for individuals with atrial fibrillation became the standard of care.”
The paper relies on this without support.
Heart failure diagnoses in Framingham have been prospectively adjudicated using a single set of diagnostic criteria since the 1960s.
“Because heart failure diagnoses in Framingham have been prospectively adjudicated using a single set of diagnostic criteria since the 1960s, the study has been a valuable source of information regarding long-term trends in the epidemiology of the condition.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Over its 74-year length, the Framingham Heart Study has demonstrated that hypertension, coronary artery disease, cardiac hypertension and diabetes are cardiovascular risk factors associated with the future development of heart failure [2,3].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [2]
Experimental — accuracy not yet measuredIn the citing paper
“These biobank efforts, pioneered in studies such as the Framingham Cohort70 and the efforts of DeCODE in Iceland71,72, now encompass a growing inventory of national cohorts in North America, Europe, Asia and beyond73–76.”
From A brief history of human disease genetics (2020) · cites this paper as [70]
In the citing paper
“We observed that the iAge gene signature was significantly associated with all-cause mortality following adjustment to multiple covariates associated with mortality, including age, sex, smoking, cholesterol levels, blood pressure, diabetes and existence of a cardiovascular disease (P = 0.02, Cox proportional hazards model, n = 2,290).”
From An inflammatory aging clock (iAge) based on deep learning tracks multimorbidity, immunosenescence, frailty and cardiovascular aging (2021) · cites this paper as [36]
Citations
Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Chobanian, A. V. (2003) · JAMA · doi:10.1001/jama.289.19.2560 · Cited by 25,386
Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., Abraham, J., Adair, T., Aggarwal, R., Ahn, S. Y., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61728-0 · Cited by 14,070
Prediction of coronary heart disease using risk factor categories
Wilson, P. W. F., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998) · Circulation · doi:10.1161/01.cir.97.18.1837 · Cited by 9,581
Self-citationHeart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300
Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., Fox, C. S., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31828124ad · Cited by 5,292
High density lipoprotein as a protective factor against coronary heart disease
Gordon, T., Castelli, W. P., Hjortland, M. C., Kannel, W. B., & Dawber, T. R. (1977) · The American Journal of Medicine · doi:10.1016/0002-9343(77)90874-9 · Cited by 5,059
Hubert, H. B., Feinleib, M., McNamara, P. M., & Castelli, W. P. (1983) · Circulation · doi:10.1161/01.cir.67.5.968 · Cited by 4,241
ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult
Hunt, S. A. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.08.022 · Cited by 4,137
The natural history of congestive heart failure: the Framingham study
McKee, P. A., Castelli, W. P., McNamara, P. M., & Kannel, W. B. (1971) · New England Journal of Medicine · doi:10.1056/nejm197112232852601 · Cited by 3,448
Research works printed but not linked: 2
- 1948, 80th US Congress, 2nd Session, Senate Report 2215, The National Heart Act, 481, 62
- Keys, 1960, Serum cholesterol and relative body weight of coronary patients in different populations, Circulation, 22, 1091, 10.1161/01.cir.22.6.1091 · DOI · Paper page
Cited by
Sorted by citations
Opportunities and obstacles for deep learning in biology and medicine
Ching, T., Himmelstein, D. S., Beaulieu-Jones, B. K., Kalinin, A. A., Do, B. T., Way, G. P., Ferrero, E., Agapow, P.-M., Zietz, M., Hoffman, M. M., et al. (2018) · Journal of The Royal Society Interface · doi:10.1098/rsif.2017.0387 · Cited by 2,310
Effects of stress on the development and progression of cardiovascular disease
Kivimäki, M., & Steptoe, A. (2018) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2017.189 · Cited by 1,197
European Society of Cardiology: cardiovascular disease statistics 2021
Timmis, A., Vardas, P. E., Townsend, N. P., Torbica, A., Katus, H. A., Smedt, D. D., Gale, C. P., Maggioni, A. P., Petersen, S. E., Huculeci, R., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab892 · Cited by 1,235
European Society of Cardiology: Cardiovascular Disease Statistics 2019
Timmis, A., Townsend, N. P., Gale, C. P., Torbica, A., Lettino, M., Petersen, S. E., Mossialos, E. A., Maggioni, A. P., Kazakiewicz, D., May, H. T., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz859 · Cited by 1,075
European Society of Cardiology: Cardiovascular Disease Statistics 2017
Timmis, A., Petersen, S. E., Belle, E. V., Townsend, N. P., Conrad, N., Kapłon‐Cieślicka, A., Kazakiewicz, D., Kavousi, M., Cvijić, M., Ignatiuk, B., et al. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehag345 · Cited by 1,001
Metadata
- Authors
- Mahmood, S. S., Levy, D., Vasan, R. S., & Wang, T. J.
- Affiliations
- Harvard University (US)
- National Institutes of Health (US)
- Boston University (US)
- Vanderbilt University (US)
- Corresponding author
- Wang, Thomas J
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 383
- Issue
- 9921
- Pages
- 999-1008
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC4159698
- OpenAlex
- W2030322782
- Semantic Scholar
- a856c8df2f6656167328ccc091cb374a1d152f60
- Cited by
- 1,622
- References
- 86
- Citations by year
- 2026: 98 · 2025: 172 · 2024: 179 · 2023: 175 · 2022: 181 · 2021: 200 · 2020: 149 · 2019: 146 · 2018: 100 · 2017: 89 · 2016: 55 · 2015: 50 · 2014: 27
- FWCI
- 7.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (N01-HC-25195)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Epidemiology › Historical and modern epidemiology studies
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- Framingham Heart Study, cardiovascular disease epidemiology, cardiovascular risk factors, Franklin D. Roosevelt, hypertensive heart disease, stroke
- MeSH terms
- Cardiovascular Diseases, Epidemiology, Humans, Longitudinal Studies, Massachusetts, Research Support as Topic, Risk Factors, History, 20th Century, History, 21st Century
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-05, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-05 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review