{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:21:22Z","timestamp":1789842082309,"version":"4.0.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,10,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Premature onset of cardiovascular disease (CVD) imposes a significant societal burden and challenges prevention efforts.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Trends in the incidence of premature CVD (before age 55, 60, or 65\u2009years, separate analysis for each threshold) were evaluated in 14\u2009464 Framingham Heart Study participants over 7 decades of observation (1950\u20132019). The change in the incidence of premature CVD (per decade) in men and women was assessed using overdispersed Poisson regression (accounting for cohort effects), adjusting for age at entry and age at onset of premature CVD within each decade. CVD was defined as a composite of fatal or nonfatal coronary heart disease, stroke or transient ischemic attack, peripheral vascular disease, and heart failure. There were 2223 first CVD events (832 in women) before age 65\u2009years during 282\u2009481 person\u2010years of observations (154\u2009587 in women) between 1950 and 2019. The age\u2010adjusted CVD incidence before age 65\u2009years decreased from 14.8 per 1000 person\u2010years (1950\u20131959) to 4.69 per 1000 person\u2010years (2010\u20132019) in men and from 7.23 per 1000 person\u2010years (1950\u20131959) to 1.73 per 1000 person\u2010years (2010\u20132019)\u00a0in women. In adjusted analyses, the incidence of premature CVD decreased per decade in men (18.4% [95% CI, 12.0%\u201324.0%], for onset before age 55\u2009years; 19.5% [95% CI, 12.0%\u201327.0%], for onset before age 60\u2009years; 21.3% [95% CI, 16.0%\u201327.0%], for onset before age 65\u2009years) and women (15.1% [95% CI, 7.0%\u201322.0%], for onset before age 55\u2009years; 14.0% [95% CI, 6.0%\u201322.0%], for onset before age 60\u2009years; 18.2% [95% CI, 12.0%\u201324.0%], for onset before age 65\u2009years). The decline in premature CVD was accompanied by a reduction in smoking and increased use of lipid\u2010lowering treatments across the decades. Incidence of premature coronary heart disease decreased, whereas the contribution of stroke to premature CVD burden increased over time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The incidence of premature CVD has decreased among White adults in the Framingham cohort over the past 70\u2009years; the residual burden of premature stroke warrants further study. Additional studies of trends in premature CVD in more racially and geographically diverse populations are warranted to elucidate the generalizability of these findings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026497","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T09:47:18Z","timestamp":1664444838000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Temporal Trends in Incidence of Premature Cardiovascular Disease Over the Past 7 Decades: The Framingham Heart Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-5970","authenticated-orcid":false,"given":"Ramachandran S.","family":"Vasan","sequence":"first","affiliation":[{"name":"Section of Preventive Medicine and Epidemiology Boston University School of Medicine Boston MA"},{"name":"Framingham Heart Study Framingham MA"},{"name":"Department of Epidemiology Boston University School of Public Health Boston MA"},{"name":"University of Texas School of Public Health San Antonio TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Boston University School of Public Health Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9157-7224","authenticated-orcid":false,"given":"Edwin R.","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine and Epidemiology Boston University School of Medicine Boston MA"},{"name":"Department of Biostatistics Boston University School of Public Health Boston MA"},{"name":"Department of Mathematics and Computer Science Eindhoven University of Technology Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa053935"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.309115"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6735a3"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.0991"},{"key":"e_1_3_1_6_2","first-page":"721","article-title":"Vital signs: avoidable deaths from heart disease, stroke, and hypertensive disease\u2010United States, 2001\u20102010","volume":"62","author":"Control for Disease Control and Prevention","year":"2013","unstructured":"Control for Disease Control and Prevention . Vital signs: avoidable deaths from heart disease, stroke, and hypertensive disease\u2010United States, 2001\u20102010. 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Respondent\u2010reported prevalence of heart disease cancer and stroke among adults aged 18 and over by selected characteristics: United States average annual selected years 1997\u20131998 through 2017\u20132018. accessed at https:\/\/www.cdc.gov\/nchs\/hus\/contents2019.htm#Table\u2010013 on 12\/08\/2021 Health United States 2019. 2021."},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003661"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318270401d"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2017.154"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000395"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000442009.06663.48"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000367"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30187-3"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.10.012"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.122.026497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:24:46Z","timestamp":1715603086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.122.026497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,4]]},"references-count":37,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2022,10,4]]}},"alternative-id":["10.1161\/JAHA.122.026497"],"URL":"https:\/\/doi.org\/10.1161\/jaha.122.026497","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,4]]},"assertion":[{"value":"2022-05-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e026497"}}