Hearts Beat Back: The Heart of New Ulm Project (HONU) presented research results comparing data from people who participated in New Ulm's 2009 and 2011 heart health screenings at the 61st Annual American College of Cardiology (ACC) Scientific Session on March 25, in Chicago.
The results showed a meaningful reduction in the heart disease risk profile among a substantial portion of the New Ulm population as indicated by the data about residents who participated in the screenings. The findings also indicated that for specific heart disease risk factors, the level of improvement is different among males and females.
HONU's 10-year goal is to reduce the number of acute heart attacks in New Ulm and the five-year goal is to reduce "modifiable" heart disease risk factors, which are those risk factors that a person can control. The short-term outcomes presented at the conference provide evidence that the project is having a positive impact on the health of New Ulm at a population level.
"We have been encouraged about the successful results in a very short period of time with the HONU Project, which we believe uses a comprehensive approach necessary to reduce heart disease," explained the study's lead investigator Thomas Knickelbine, MD, cardiologist at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis and medical director with HONU.
Knickelbine added that all players in the community feel accountable for improving care - from the employers to the providers to the individual. HONU is addressing prevention of risk level through health care initiatives, worksite programs and broad community initiatives. Interventions range from individual health education and behavior change work to policy and social marketing and re-engineering strategies.
"Because New Ulm is the single medical center in the community, all residents are connected to a common set of health care providers and a common system for electronic health records," said study co-investigator Jackie Boucher, MS, vice president of education at the Minneapolis Heart Institute Foundation. "This is uniquely helpful in providing us with a comprehensive understanding of the heart disease risk levels that we can communicate back to the residents and to the medical providers to close the loop of the patient care continuum."
For residents of the New Ulm zip code, free heart health screenings were offered to any adult first in 2009 when the program began and again in 2011. Screenings were held in a variety of locations, including worksites, New Ulm Medical Center, churches and other community spaces. Those participating in both years of the screenings comprised the study group, which included 1,766 adults.
During the screenings, study participants completed a questionnaire and biometric measures (i.e., blood pressure, height, weight, waist circumference and fasting blood draw). The screening tool included questions on various lifestyle behaviors, including smoking, physical activity level, number of daily fruit and vegetable servings, stress level, alcohol consumption and medication adherence. After the screening, high-risk individuals were targeted for more aggressive treatment with direct phone calls to provide behavioral lifestyle change counseling, medication initiation and scheduling of follow-up visits with primary care providers at the New Ulm Medical Center.
The researchers found that people who returned for screening in 2011 were more likely to be female (64 percent of the returnees in 2011 were women), less likely to be smokers (5.3 percent in 2011 vs. 6.3 percent in 2009), less likely to be obese (35.6 percent in 2011 vs. 36 percent in 2009) or less likely to have diabetes (23.2 percent in 2011 vs. 26.6 in 2009).
Researchers found reductions in levels of smoking, stress, high blood pressure, high cholesterol, fasting glucose and high-sensitivity C-reactive protein (hs-CRP) across both males and females, as well as an increase in people who are getting the recommended 150 minutes of exercise per week.
The data comparison also showed gender-specific differences. Women had larger decreases in stress levels and larger increases in fruit and vegetable consumption compared with men, and men were more likely to start blood pressure medications. Also, hs-CRP decreases were more pronounced in women than men, despite similar changes in aspirin use and non-significant gender differences in cholesterol medication use. The study authors hypothesize that this may be related to increased exercise and reduced stress levels.
"In general, the behavioral change initiatives are having a greater impact on the female population of this widespread preventive program," said Knickelbine. "We will continue to monitor the entire population within New Ulm, and provide feedback to both individuals and the community."
The Heart of New Ulm Project's website now includes links to the project's scientific research publications, conference presentations and poster sessions.
Visit www.heartsbeatback.org and click on "Research Publications and Presentations" in the lower right-hand corner.