Wise at heart
Psaty notes that a gene search is just the first step. Each gene may make only a small contribution to heart attack risk but, added to other factors, will help to build a picture of who is most at risk.

Certain genes may also indicate how a person will respond to medication, someday helping doctors select the best treatment for a patient, O'Donnell says. Or they may help scientists understand how the cardiovascular system works, ultimately leading to better therapies.

Other SHARe studies have linked DNA changes to gout, cholesterol levels, heart failure and blood pressure.

Although the Framingham study is heart-focused, research using the data goes well beyond the cardiovascular system. Scientists who obtain additional funding can use Framingham data to study such diverse topics as diabetes, lung disease, kidney function, back pain and drinking habits.

Lead Framingham investigator Dr. Philip Wolf of the Boston University School of Medicine has used the study for research on brain health, looking at factors that affect a person's risk for stroke or dementia. In 1991, he and others published the Framingham stroke risk profile, which uses factors such as age and blood pressure to assess how likely a person is to suffer stroke in the near future.

Wolf has also added MRIs to the volley of tests that a Framingham subject may undergo. In a 2004 paper in the journal Neurology, he and others reported that as brain volume decreases, the stroke risk score goes up. This and other studies have shown that some of the same factors that lead to heart disease can also lead to stroke.

"The impact of vascular risk factors on the brain and brain function in normal people is much greater than we had perceived," says Dr. Charles DeCarli of UC Davis, who collaborates with Wolf on the study.

In another, as-yet-unpublished study, DeCarli studied Framingham subjects whose parents suffered dementia. As early as age 52, some people with that family history show signs of "moving off the trajectory of normal aging," he says, with changes in brain structure and thinking ability.

That means people in their 40s and 50s should be thinking about what they can do to maintain brain function, DeCarli says. Some of the strategies used to battle heart disease, such as exercise, may apply. "We need to really be practicing body health for brain health early in life," he says.

Framingham is now on its third generation of subjects, with no sign of stopping, says Dr. Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute, which funds Framingham.

"If we're all here in another decade or so," she says, "we'll look forward to enrolling the fourth generation."





Key Framingham findings

In 60 years, the Framingham Heart Study has published approximately 1,200 scientific papers. Below are a few landmark discoveries.

* 1960: Smoking increases risk for heart disease.

* 1961: High cholesterol and high blood pressure are risk factors for heart disease.

* 1967: Obesity increases one's chances for heart disease; exercise reduces risk.

* 1970: High blood pressure increases risk of stroke.

* 1976: Risk for heart disease in women increases after menopause.

* 1998: The Framingham Heart Study publishes its cardiovascular risk calculator to estimate a person's chances of developing heart problems within the next decade.

-- Amber Dance