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The Framingham Study

William B. Kannel, MD; Philip A. Wolf, MD; Joel Verter, MS; Patricia M. McNamara

JAMA. 1996;276(15):1269-1278.

Abstract
Control of hypertension, labile or fixed, systolic or diastolic, at any age, in either sex appears to be central to prevention of atherothrombotic brain infarction (ABI). Prospectively, hypertension proved the most common and potent precursor of ABI's. Its contribution was direct and could not be attributed to factors related both to stroke and hypertension. Asymptomatic, causal "hypertension" was associated with a risk of ABI about four times that of normotensives. The probability of occurrence of an ABI was predicted no better with both blood pressure measurements or the mean arterial pressure than with systolic alone. Since there was no diminishing impact of systolic pressure with advancing age, the concept that systolic elevations are, even in the aged, innocuous is premature. Comparing normotensives and hypertensives in each sex, women did not tolerate hypertension better than men.

Author Affiliations
From the Heart Disease Epidemiology Study, Framingham, Mass, and the National Heart Institute, Washington, DC (Dr. Kannel and Miss McNamara); the Neurology Department, Boston University School of Medicine, Boston (Dr. Wolf); and the Biometrics Research Section, National Heart Institute, Bethesda, Md (Mr. Verter).

Footnotes
Read before the Section on Preventive Medicine at the 118th annual convention of the American Medical Association, New York, July 16, 1969.

Reprint requests to 25 Evergreen St, Framington, Mass 01701 (Dr. Kannel).

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