Changes in cardiovascular risk factors after 5 years of implementation of a population based program to reduce cardiovascular disease: The Heart of New Ulm Project.
BACKGROUND Population based interventions aimed at reducing cardiovascular disease (CVD) hold significant potential and will be increasingly relied upon as the model for health care changes in the United States. METHODS The Heart of New Ulm Project is a population based project with health care, community, and workplace interventions addressing multiple levels of the social ecological model designed to reduce modifiable CVD risk factors in rural New Ulm, MN. The community is served by one health system, enabling the use of electronic health record data for surveillance. Electronic health record data were extracted at baseline (2008 2009) and 2 follow up periods (2010 2011, 2012 2013) for residents aged 40 to 79 years. Generalized estimating equations were used to fit longitudinal models of the risk factors. RESULTS Of 7,855 residents in the target population, 80% had electronic health record data for each period. The prevalence of at goal (blood pressure [BP] <140/90 mm Hg) and (low density lipoprotein cholesterol [LDL C] <130 mg/dL) increased from 79.3% to 86.4% and 68.9% to 71.1% respectively, from baseline to 5 years, with the largest reductions in BP and LDL C seen in individuals not at goal at baseline. Blood pressure and lipid lowering medication use increased from 41.8% to 44.0% and 25.3% to 29.1% respectively. The proportion at goal for glucose increased from 46.9% to 48.2% The prevalence body mass index <30 kg/m(2) (55% did not change, whereas the proportion at goal for high density lipoprotein decreased from 63.8% to 58% and smoking showed an increase from 11.3% to 13.6% CONCLUSION In a community participating in a multifaceted, population based project aimed at reducing modifiable CVD risk factors, significant improvements in BP, LDL C, and glucose were observed for 5 years, and body mass index remained stable in a state where obesity was increasing.
American heart journal