Essentials of Biostatistics in Public Health, Third Edition

Lisa M. Sullivan

Integrative Exercises (Edited for COH 602 Biostatistics)

Copyright © 2018 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 1

The Framingham Heart Study—Integrative Exercises with Solutions

Background

The National Heart, Lung, and Blood Institute (NHLBI)1 created a teaching dataset that

includes real but anonymized data collected as part of the Framingham Heart Study. The Framingham

Heart Study is one of the most influential and longest running epidemiological studies of risk factors

for cardiovascular disease ever run. The study started in 1948 and continues today to collect extensive

data from original participants, their children, and their children’s children. Much of what we know

about cardiovascular disease was discovered by investigators involved in the Framingham Heart Study.

In fact, studies to date using data collected in the Framingham Heart study have resulted in over 3000

publications in high impact, peer-reviewed medical journals.

The Framingham Heart Study has been widely discussed in the media. WGBH in Boston

produced a video documentary for PBS entitled “The Hidden Epidemic: Heart Disease in America”

that details the history of heart disease in this country and highlights the Framingham Heart Study.2 In

2007, CBS News did a story on the study, its participants, and its impact.3 Additionally, research

results from the Framingham Heart Study are communicated widely, most recently highlighting the

discovery of a gene that may promote obesity4 and new data showing declining rates of dementia.5

Interested readers can visit the Framingham Heart Study website for a detailed history of this

incredible study and its many contributions to preventive medicine.6

1 http://www.nhlbi.nih.gov/ 2 http://www.pbs.org/wgbh/takeonestep/heart/ 3 http://www.cbsnews.com/videos/landmark-heart-study/ 4 http://www.cbsnews.com/news/how-a-fat-gene-may-influence-your-weight/ 5 http://www.cbsnews.com/news/dementia-alzheimers-risk-signs-of-hope-study/ 6 https://www.framinghamheartstudy.org/about-fhs/history.php/

Essentials of Biostatistics in Public Health, Third Edition

Lisa M. Sullivan

Integrative Exercises (Edited for COH 602 Biostatistics)

Copyright © 2018 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 2

Dataset for Analyses

NHLBI created a longitudinal teaching dataset includes clinical, laboratory, and outcome data

on n = 4434 participants. Each participant has between one and three observations—which represent

examinations held approximately 6 years apart. A detailed description of the Framingham Heart Study

dataset and other public use datasets available from NHLBI are available on the NHLBI Biologic

Specimen and Data Repository Information Coordinating Center (BioLINCC) website.

The dataset available for analysis includes only data collected at the first examination for each

participant (n = 4434). The dataset is available as comma separated values (.csv) file.

Variables

The following variables are available in each dataset for analysis (extracted from the complete

documentation file, available on the NHLBI BioLINCC website 7).

Variable Name Description Coding Details/Range

RANDID Unique identification number for each participant 2248-9999312

SEX Participant sex 1 = Male, 2 = Female

PERIOD Exam cycle 1, 2, 3

TIME Number of days since first (baseline) exam 0–4854

AGE Age at exam, years 32–81

SYSBP Systolic blood pressure, mmHg 83–295

DIABP Diastolic blood pressure, mmHg 30–150

BPMEDS Use of anti-hypertensive medication 0 = No, 1 = Yes

CURSMOKE Currently smoking cigarettes 0 = No, 1 = Yes

CIGPDAY Number of cigarettes smoked per day 0 (non-smoker)–90

TOTCHOL Total serum cholesterol, mg/dL 107–696

HDLC* High density lipoprotein cholesterol, mg/dL 10–189

LDLC* Low density lipoprotein cholesterol, mg/dL 20–565

BMI Body mass index = weight (kg)/height (m)2 14–57

GLUCOSE Serum glucose, mg/dL 39–478

DIABETES Diabetes (glucose > 200 mg/dL or on treatment) 0 = No, 1 = Yes

HEARTRTE Heart rate, beats/minute 37–220

PREVAP Prevalent angina pectoris 0 = No, 1 = Yes

PREVCHD Prevalent coronary heart disease (CHD) 0 = No, 1 = Yes

PREVMI Prevalent myocardial infarction (MI) 0 = No, 1 = Yes

7 https://biolincc.nhlbi.nih.gov/static/studies/teaching/framdoc.pdf?link_time=2016-07-06_14:21:55.514359

Essentials of Biostatistics in Public Health, Third Edition

Lisa M. Sullivan

Integrative Exercises (Edited for COH 602 Biostatistics)

Copyright © 2018 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 3

PREVSTRK Prevalent stroke 0 = No, 1 = Yes

PREVHYP Prevalent hypertension 0 = No, 1 = Yes

The following are outcome events coded 1 if the event occurred during the

follow-up (only the first event is recorded).

ANGINA Angina pectoris 0 = No, 1 = Yes

HOSPMI Hospitalized for MI 0 = No, 1 = Yes

MI_FCHD Hospitalized for MI or fatal CHD 0 = No, 1 = Yes

ANYCHD Any coronary heart disease event 0 = No, 1 = Yes

STROKE Stroke 0 = No, 1 = Yes

CVD Cardiovascular disease 0 = No, 1 = Yes

HYPERTEN Hypertension 0 = No, 1 = Yes

DEATH Death from any cause 0 = No, 1 = Yes

The following are numbers of days from the first (baseline) exam to the first event

during the follow-up. If no event occurred, time is end of follow-up,

death, or last known contact date.

TIMEAP Time from baseline to first angina

TIMEMI Time from baseline to first myocardial infarction

TIMEMIFC Time from baseline to first MI or fatal CHD

TIMECHD Time from baseline to first CHD

TIMESTRK Time from baseline to first stroke

TIMECVD Time from baseline to first cardiovascular disease

TIMEHYP Time from baseline to first hypertension

TIMEDTH Time from baseline to death

*Available only at period = 3 exam, missing otherwise

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