Diseases of the Chest steadily expanded its remit to include more cardiovascular reports, as the interrelationship between heart and lung function became ever more intertwined. The Framingham Study, published in Diseases of the Chest in 1969, has been the source of so many milestone publications resulting in major changes to public health that it is difficult to select one study to represent its overarching impact.
It is 60 years since this longitudinal study of cardiac function among the population of a small town in Massachusetts began assimilating data. Twenty years after it started, Kannel and colleagues1 reported on BP and the risk of coronary heart disease (CHD). They observed a relationship between BP and CHD in each sex at varying ages. Considering the population size of this study, to follow up on 80% of patients in a community setting was impressive, thus giving a high level of credibility to the results. On analyzing > 5,000 individuals, it was established that hypertension and heart disease are associated, in particular with the level of BP. They observed women did not tolerate hypertension better than men, having the same risk of eventual CHD. The authors advocated early, vigorous, and sustained control of elevated BP, something we are still striving for in many patients some 40 years later.