NR503 Discussion 1.docx - Epidemiology is described as the...

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Epidemiology is described as the study of how disease is distributed within a population (Gordis, 2014). Some of the objectives of epidemiology are to evaluate the causes and risk factors, history and level of occurrence of a disease within a specified population (Gordis, 2014).The Framingham Heart Study (FHS) is an example of an accomplishment that has had a significant impact on healthcare, specifically from an epidemiological standpoint through the study of cardiovascular disease and evaluation of risk factors. Healthy People 2020 reports that one in three adults in the United States has some formof heart disease and is the leading cause of death in the United States (U.S. Department of Health and Human Services, 2017). The goal of the Healthy People 2020 initiative is to reduce the prevalence and expense of cardiovascular disease through improved prevention, detection and treatment and has identified several modifiable risk factors that are a focus of interventions(U.S. Department of Health and Human Services, 2017). Several of these risk factors were initially identified through the FHS (Tsao & Vasan, 2015). Shortly after President Roosevelt’s death due to uncontrolled hypertension and cerebral hemorrhage in 1945, President Truman signed the National Heart Act which led to the development of the National Heart Institute, now known as the National Heart, Lung, and BloodInstitute (Mahmood, Levy, Vasan, & Wang, 2014). Around the same time, the United States Public Health Service selected Framingham Massachusetts as the site for a longitudinal study of heart disease that would focus on the development of the disease within a general adult population (Mahmood et al., 2014). The first volunteer in the FHS was evaluated in 1948 and in 1949, the National Heart Institute assumed supervision of the study with Dr. Gilcin Meadors as the study director (Mahmood et al, 2014). The FHS was the first long term study of its kind in the United States to investigate the development of heart disease in a large cohort (Tsao & Vasan, 2015). The initial study cohort consisted of 5209 patients and first reports from the study were presented in 1957 (Mahmood et al., 2014). At the time, systolic blood pressure was thought to have a minimal role in hypertension, and treatment was focused primarily on diastolic blood pressure (Mahmood et al., 2014). The FHS was instrumental in identifying that hypertension, specifically elevated systolic blood pressure is strongly associated with the development of heart disease and stroke (Mahmood et al., 2014). In addition to blood pressure, this study also identified weight, age, cholesterol and diabetes as risk factors associated with the development of heart disease, and allowed for treatment to be initiated in the preclinical phase of the disease (Tsao & Vasan, 2015). One of the main outcomes of the FHS was its utilization of its data to determine people who were most likely to have cardiovascular disease or suffer from a cardiovascular event, and allowed the development of risk factors associated with heart disease (Mahmood et al., 2014).

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