Stratifying the patient at risk from coronary disease: new insights from the Framingham Heart Study.

Although cardiovascular disease remains the leading cause of death in the United States, cardiovascular disease mortality has decreased steadily during the past 2 decades. This trend is largely attributable to improved detection and management of cardiovascular risk factors, in which the Framingham Heart Study has played a major role. This article examines some of the risk factors associated with coronary heart disease, notably, advancing age, hypertension, left ventricular hypertrophy, smoking, elevated serum cholesterol, and reduced high-density lipoprotein, all of which have been investigated by the Framingham Heart Study. In addition, new data are presented from a multidimensional model of coronary heart disease. This is a novel approach that takes into account the interactions of multiple risk factors and their contribution to overall coronary heart disease risk.