Assessment of mortality and incident cardiovascular events (coronary heart disease, congestive heart failure and/or atherothrombotic brain infarction) in 1,348 participants in the Framingham Heart Study has identified an increased risk of coronary heart disease in people with symptomatic—but not radiographic—hand osteoarthritis (OA). The 540 patients with radiographic hand OA (40.1%) seemed not to be at increased risk of cardiovascular events or mortality, whereas the 186 participants (13.8%) with symptomatic hand OA had a hazard ratio of 2.26 (95% CI 1.22–4.18) for incident myocardial infarction and/or coronary insufficiency syndrome.