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Wednesday, September 11, 2013

Sequester Reduces Funds For Longterm Heart Study

Dr. T. Royle Dawber, was the director  of the Framingham Heart Study, from 1949-1966. He checks an X-Ray in his office on April 7, 1952. (Frank C. Curtin/AP)

Dr. T. Royle Dawber, was the director of the Framingham Heart Study, from 1949-1966. He checks an X-Ray in his office on April 7, 1952. (Frank C. Curtin/AP)

The Framingham Heart Study is considered one of the most important research projects in medical history.

Over the last 65 years, data from the study has been used to develop and test technologies and treatments that have saved millions of lives and hundreds of billions of dollars in health care costs.

But now, the mandated across-the-board budget cuts, known as the sequester, are dramatically reducing federal funding for the research.

From the Here & Now Contributors Network, Bruce Gellerman of WBUR reports.

Reporter

Transcript

JEREMY HOBSON, HOST:

It's HERE AND NOW. The Framingham heart study is considered one of the most important research projects in medical history. Over the last 65 years, data from the study have been used to develop and test technologies and treatment that have saved millions of lives and hundreds of billions of dollars in health care costs.

But now the mandated, across-the-board budget cuts known as sequester are dramatically reducing federal funding for the research. From the HERE AND NOW contributors' network, WBUR's Bruce Gellerman has our story about the rich history and uncertain future of the Framingham heart study.

BRUCE GELLERMAN: Between 1900 and the end of World War II, the death rate from heart disease in the U.S. nearly tripled. Changes in diet and industrial lifestyle made heart disease the leading cause of death in the U.S., killing more people in a year than all the American soldiers who died in action during the second world war.

The wakeup call came on April 12, 1945.

UNIDENTIFIED MAN: We interrupt this program to bring you a special news bulletin from CBS News. A press association has just announced that President Roosevelt is dead. The president died of a cerebral hemorrhage.

GELLERMAN: The underlying causes of Roosevelt's stroke were cardiovascular diseases, heart failure and hypertension. Three years later, the federal government launched an unprecedented effort to determine why so many Americans were dying from cardiovascular diseases. For their study, scientists chose a typical U.S. town, Framingham, Massachusetts.

It was a giant step forward in medical research. Boy these are steep.

JESSE ESTES: Yes, great exercise, good for the heart.

GELLERMAN: Jesse Estes leads the way up to the second-floor offices of the Framingham heart study, where she serves as the executive assistant. The study and its vast archive are unique.

ESTES: So this is our records room. This is it, the treasure trove of information, yes, for all of the exams. These are all of the records for the history of the study.

GELLERMAN: The floor-to-ceiling files contain the detailed medical exams of three generations of Framingham residents, nearly 15,000 people, including those of Karen Kylie LaChance(ph). She stands before an old photo of the clinic where the Framingham study was once located.

KAREN KYLIE LACHANCE: I think that is circa late '70s because I do remember having my - I think maybe my first exam was in that building.

GELLERMAN: Karen's parents, Bill and Flo Kylie(ph), her two sisters and a brother and her 33-year-old son all volunteered to serve without pay in the Framingham heart study.

LACHANCE: The passion is kind of passed on within the family. You know, people are proud to be participating. It's unique. And I've had people say oh, I'd like to join that, I'm interested in that, and I said sorry, you can't, it's a closed club.

(LAUGHTER)

LACHANCE: You had to be an original descendent from a, you know, a cohort.

GELLERMAN: There are still about 100 original Framingham participants or cohorts alive. The youngest is 95. Every few years, each person in the study comes in and undergoes an extensive physical and mental exam. The exams are literally and figuratively the lifeblood of the Framingham study, providing new data to keep the research up to date.

LACHANCE: Back then people didn't have annual physicals. That was kind of for the elite. And a lot of the residents in Framingham were invited to participate, and they've been able to study our habits, our nutrition and tracked us, for me 42 years now, and, you know, whatever the outcome is going to be for me, it's got to help to, you know, enlarge the body of science down the road.

Individually we can't be very effective, but I think as a collective database, we're invaluable.

GELLERMAN: Thanks in part to the Framingham study, deaths from heart disease have been cut by more than 70 percent over the past four decades. The study was the first to link smoking and stress to heart disease and identified cholesterol and obesity as risk factors. In fact the very term risk factor, or factors of risk, was coined by Framingham researchers.

An automated machine analyzes blood samples from participants, noting genetic markers. As times and technology have changed, so too has the Framingham study. In 2009, President Obama had high praise for the advances.

PRESIDENT BARACK OBAMA: Since 1948, for example, researchers have been following generations of residents in the town of Framingham, Massachusetts, to better understand the cause of cardiovascular illness. Now we have a chance to study the DNA of these participants and connect what we know after decades of observation to what we'll soon know about their genetic makeup.

GELLERMAN: Today Framingham researchers are looking beyond heart disease. They're using the huge database to search for the genetic origins of Alzheimer's disease, diabetes and the aging process itself. But the 65-year-old study is in jeopardy.

DANIEL LEVY: We're getting a global haircut, to a certain extent.

GELLERMAN: Dr. Daniel Levy is director of Framingham heart study. He's been with it for 29 years, and there have been cuts before but nothing like the sequester. The NIH is cutting $4 million from Framingham's $9 million core contract. Dr. Levy is reluctant to discuss the cuts. Clearly the subject has touched a nerve at the NIH.

At the last minute, it flew a public affairs office to Boston to sit in and monitor my interview with Dr. Levy. How are you going to make up the budget cuts? What are you going to do?

LEVY: That's not an area I'm comfortable discussing in terms of the budget.

GELLERMAN: What about in terms of layoffs. Are you going to have to have layoffs?

LEVY: There will be layoffs, and that's a matter that you can discuss further with Boston University.

GELLERMAN: The Framingham study is run in partnership with Boston University. The federal funds are administered by the dean of BU's school of medicine, Dr. Karen Antman.

KAREN ANTMAN: We have never had this kind of cut. We were ready to take a hit. We thought that certainly a 10 percent hit was fully what we expected. We even expected a 25 percent hit. We did not expect a 40 percent hit.

GELLERMAN: The Framingham study will continue, but the $4 million cut means the end of the medical exams. Starting in 2015, participants will just answer health questions by phone. But Dr. Antman says ending the examinations will affect another $28 million worth of research at BU that also depend upon the data. That means laying off 19 employees at Framingham.

ANTMAN: If we let these people go because we don't have an exam and because we have this cut, and we have to, then when we do get funding for the exams, and I'm sure we will, bringing them back or retraining a brand new group will actually cost more. So we'd like to actually save these jobs and future money.

GELLERMAN: Dr. Antman is optimistic funding for the Framingham exams will eventually be restored, but when and at what costs in terms of scientific discoveries delayed and lives potentially lost is unknown. There are hopes President Obama might personally intervene and restore Framingham's funding. It happened once before.

In 1969, the director of the NIH, citing deep budget problems, decided to end the project, but when town residents and participants began sending in donations to Washington to keep it going, President Richard Nixon had a change of heart and saved the Framingham Heart Study. For HERE AND NOW, I'm Bruce Gellerman.

(SOUNDBITE OF MUSIC)

MEGHNA CHAKRABARTI, HOST:

Well, checking in on social media now, a lot of you had some pretty strong reaction to President Obama's address on Syria last night. It's all on our Facebook page.

HOBSON: Guy Western wrote the world will indeed be going down a slippery slope if one mad dictator is seen as having gained advantage through the use of chemical weapons which are, by their very nature, terroristic. Patrick McNichols said, amazing what a somewhat united world can do. If only Putin had come to his senses two years ago.

CHAKRABARTI: But Lynette Marrow writes, do not trust him. And Dave Zbaracki echoes that with really, trust the Russians?

HOBSON: We'd love to hear your thoughts. Go to Facebook.com/hereandnowradio and join the conversation. You can also go to hereandnow.org.

CHAKRABARTI: Coming up a little later in the show, the call for high-tech surveillance along the U.S.-Mexico border is worth hundreds of millions of dollars to companies putting in bids to do the work. We'll take a look at how that is playing out. Latest news is next, HERE AND NOW. Transcript provided by NPR, Copyright NPR.


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