Core 2. Epidemiology and Prevention of CV Disease: Physiology, Pharmacology and Lifestyle
Session Title: Prevention and Clinical Trials
Abstract 15899: Improvements in Cardiovascular Disease Risk Factors After Five Years of a Population-Based Intervention: The Heart of New Ulm Project
Objective: We aimed to assess population-level changes in cardiovascular disease (CVD) risk factors over the first 5 years of The Heart of New Ulm Project (HONU).
Methods: Started in 2009, HONU is a 10-year community intervention aimed at reducing modifiable CVD risk factors in rural New Ulm, MN. Interventions are delivered at all levels of the social ecological model through healthcare, worksite, and community settings. The community is served by one health system, enabling use of electronic health record (EHR) for ongoing CVD risk factor surveillance. EHR data was extracted for baseline (2008-2009) and two follow-up periods (2010-2011, 2012-2013) for residents age 40-79. Generalized estimating equations (GEE) were used to model the risk factors during the study period and account for within-subject correlation due to repeated measures. Covariates included time period, age, and gender. To examine changes stratified by baseline risk factor, analysis was limited to the cohort of individuals with data at baseline for each risk factor being examined.
Results: Of the 7,855 residents in the target population, 92-97% had visits during at least one time period. In each time period, data availability for blood pressure (BP) was 88-96% and 55-67% for lipids. The proportion of residents with BP at goal (<140/90) increased from 78.7% to 84.3% from baseline to the 5-year follow-up. The proportion with LDL at goal (< 130) increased from 68% to 72%. BMI, glucose, and smoking did not improve. The largest reductions in BP and LDL occurred among those with elevated levels at baseline. Individuals not at goal at baseline experienced a significant reduction in mean systolic BP (148.1 to 133.1) and LDL (152.6 to 131.2).
Conclusion: Significant improvement in BP and lipids were noted over 5 years in the HONU project. The bulk of these population-level improvements seem to be driven by better risk factor control among the sizeable number of individuals who were not at goal at baseline.