78 Years In, BU-Led Framingham Heart Study Still Relies on Volunteers Who Keep Coming Back

The Framingham Heart Study, the nation's longest-running cohort study of cardiovascular health, is entering its 78th year with just over 6,150 active participants and a new principal investigator focused on keeping families engaged across generations, according to a feature published Tuesday by Boston University's research news site, The Brink.

The government launched the study in 1948. It has been run as a partnership between Boston University and the National Heart, Lung, and Blood Institute since 1971. Many of its researchers come from BU's Chobanian & Avedisian School of Medicine and Boston Medical Center, the university's primary teaching hospital, as well as other Boston institutions.

Origins and findings

Congress commissioned the study at a time of rising deaths from cardiovascular disease, when its causes were not well understood. The study began with 5,209 Framingham residents between the ages of 30 and 62 who had no known heart disease. All members of that original cohort have since died, but their children, grandchildren and spouses now participate in offspring cohorts. In some families, as many as 50 or 60 members have volunteered, BU reported.

Two additional "omni" cohorts were added: the first recruited in the 1990s to better reflect Framingham's changing demographics, and the second made up of their offspring and others.

According to BU, research drawn from the study has shown that weight and cholesterol levels are key risk factors for heart disease; that smoking and a sedentary lifestyle raise mortality; that hypertension is a key risk factor for stroke and heart failure; that diabetes contributes to clogged arteries and heart failure risk; that stress can contribute to heart problems; and that risk-factor profiles can accurately estimate a person's 10-year risk of heart attack and stroke.

"We can learn a lot from a single snapshot if we see someone once, but we learn exponentially more if we see them in serial examinations—about how things change, about how we age," said Dr. Donald Lloyd-Jones, who became the study's sixth principal investigator in January 2025. Lloyd-Jones is chief of preventive medicine at BU's medical school and Boston Medical Center and a past president of the American Heart Association, which gave him its Gold Heart Award this year.

The current exam cycle

Many participants have moved away from the area but continue to take part. About 1,100 will be seen in the current exam cycle, which began in December 2025 and runs through June 2027. A typical visit involves more than four hours of tests, questions, measurements, scans, blood draws and a 100-question diet survey, and sometimes additional exams by scientists who have won grants to use the study's data for research on Alzheimer's disease and other conditions.

BU described two sisters who grew up in Framingham and now live in Kissimmee, Florida, who slept in their rental car outside study headquarters in February 2025 after a delayed flight rather than miss early-morning appointments. "We wanted to help with research," Ximena Martinez said. "And it's helpful for us to know our health."

Jim Carboneau of Holliston, a retired teacher and school administrator, has participated for 54 years as part of the second-generation cohort. His parents, three uncles and two aunts were in the original cohort, and his children and a nephew are in the third. "I have heart issues, and science has saved me. My wife had cancer, and science saved her. So we will do anything to promote and advance the cause," he said.

New research directions

Lloyd-Jones said multiple generations of data help researchers separate inherited conditions from those tied to shared environments. "We know that genetics create the propensity for health or disease, and environment plays with those genetics to pull the trigger on either good or bad outcomes," he said.

The study's Brain Aging Program, funded by the National Institute on Aging, measures speech patterns, walking speed and blood biomarkers to detect early signs of cognitive impairment. Other current projects use advanced imaging and artificial intelligence to analyze blood vessels at the back of the eye, track how participants follow medication instructions, and examine platelet function, bone density loss and continuous glucose monitoring in people without diabetes, according to BU.

Keeping participants

Maureen Valentino, the study's recruitment manager for 28 years, said participants understand "that they are part of a bigger picture, that they are changing public health." Lloyd-Jones called her "one of the most important assets of the Framingham Heart Study, because she cares."

The study has recently begun offering small stipends to participants and now offers alternatives to the fully in-person exam, including home visits and Zoom interviews. Valentino said that with those options, participation is at nearly 100 percent.