From Framingham to North Karelia: from descriptive epidemiology to public health action.

The Framingham study was a landmark study that, already in the 1960s, gave strong evidence as to the likely causal role of several lifestyle-linked factors in the development of cardiovascular diseases (CVDs). Men in Finland had at that time the highest mortality rates of coronary heart disease in the world, a finding that raised much local concern. In 1972, a pioneering project by a young leadership team and with many partners, including World Health Organization, was started to change the situation. The project was based on the results for Framingham and some other classical studies to carry out a comprehensive prevention program to reduce the risk factor levels in the population through general lifestyle changes in the pilot area of North Karelia. Later on, the work was transferred to national level. Over the years, great reductions in the population levels of the risk factors took place, associated with dramatic reduction in age-adjusted CVD mortality rates and improvement in public health. The experience of diminishing the prevalence of risk factors in the population is a powerful demonstration of how the CVD epidemic can be successfully confronted-thatis, how the Framingham results can effectively be used for major progress in public health. Copyright 2010 Elsevier Inc. All rights reserved.