Blood pressure and cardiovascular disease: tracing the steps from Framingham

Around one-quarter of the world's adult population are defined as "hypertensive" however a much greater proportion are at risk of blood pressure-related disease because of the nature of the association between blood pressure and cardiovascular risk. The Framingham Study, together with other landmark observational studies, has been instrumental in elucidating this relationship. As early as the 1960s, Framingham showed that the association between blood pressure and cardiovascular risk was continuous and linear and was consistent across different age groups and for a range of major cardiovascular events. As the first major observational study to include substantial numbers of women, it was also able to debunk the myth that women "could tolerate blood pressure well". In more recent decades, Framingham has been central to the development of the notion of absolute risk and the importance of blood pressure alongside other risk factors. Much of our current understanding of the role blood pressure in cardiovascular disease can be attributed to decades of high quality research from Framingham.