Deciphering the causes of cardiovascular and other complex diseases in populations: achievements, challenges, opportunities, and approaches.

This paper provides an overview of key achievements of the Framingham Heart Study and identifies areas and approaches for future research in cardiovascular disease epidemiology and prevention. There is a need for a range of different studies using diverse designs (i.e. case-control, cohort, multi-community, birth cohort, family-based cohorts and randomized trials) in different settings and involving multiple ethnic groups. Incorporation of a range of new disciplines, such as genetics, behavioural sciences, social epidemiology, measures of the environment, geography, and health policy are required to understand the root determinants of cardiovascular diseases.