Fighting High Blood Pressure Longer, Harder, with a More Focused Campaign

The Heart of New Ulm project is a collaborative effort of Allina Health, the Minneapolis Heart Institute Foundation, and the community of New Ulm. New Ulm Medical Center, an Allina-owned hospital and clinic that the primary care provider for the small town of New Ulm and the farm families that live near it. The services of the project are available to anyone in the city who is over the age of 18, although the program focuses on heart health of the 7,900 residents of the New Ulm zip code who are age 40 to 79. The Heart of New Ulm Project expects that change will take a while. The program began in 2009 and will continue to be offered every other year until 2019.

Anyone who lives in or near New Ulm can get a free screening for cardiovascular risk factors once a year. This isn't just a quick blood pressure check at a table in a mall. The Heart of New Ulm clinicians screen for high blood pressure, high cholesterol, diabetes, height, weight, and family history.

Referrals to doctors for follow-up are also made at the time the risk report is given to the participant. Screenings are made available from April through December every other year to monitor progress and to diagnose new cases of hypertension, high cholesterol, and diabetes as soon as possible.

The program also sponsors community walkathons and pot luck dinners because local residents like them, and to provide an opportunity for further education and follow-up. The Heart of New Ulm project has sought to make cardiovascular health a community concern and a community effort. But how well has it worked?

• A total of 3,123 of the 7,900 adults in the target population were screened in 2009. Two years later 1,455 returned for follow-up screening.
• A slight majority (52%)  of the adults who had uncontrolled high blood pressure when they were screened in 2009 had controlled blood pressure in 2011.
• An overwhelming majority (81%) of adults who had normal blood pressure during the 2009 screening still had normal blood pressure during the 2011 screening.
• On average, adults who had normal blood pressure in 2009 had slightly better blood pressure (an average of 2 points lower diastolic pressure) in 2011.
• 14% more adults in New Ulm were on medication for high blood pressure in 2011 than in 2009.

Ideally, of course, no one would need medication for high blood pressure. We'd all eat just the right diet, have just the right amount of stress in our lives to keep us productive and engaged in life activities, and we'd all be the perfect weight for our height and body type. But getting more people on medications in New Ulm, Minnesota, statisticians believe, will result in 20% fewer heart attacks and 30% fewer strokes.

What does New Ulm's experience tell us?

See Also: Primary Prevention of Hypertension

It's not enough to give people a report of their numbers. It's also necessary to follow up with professional care and with ongoing education and fun social activities. The 700 to 1000 longer lives out of the 7,900 residents of New Ulm targeted by this outreach are worth the effort.