title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  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%.
  
  
  
  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.
authors.affiliation: Division of Applied Research, Allina Health, Minneapolis, MN. Electronic address: Abbey.sidebottom@allina.com.
authors.forename: Abbey C
authors.initials: AC
authors.lastname: Sidebottom
authors.affiliation: Division of Applied Research, Allina Health, Minneapolis, MN.
authors.forename: Arthur
authors.initials: A
authors.lastname: Sillah
authors.affiliation: Minneapolis Heart Institute, Minneapolis, MN; Minneapolis Heart Institute Foundation, Minneapolis, MN.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Miedema
authors.affiliation: Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN.
authors.forename: David M
authors.initials: DM
authors.lastname: Vock
authors.affiliation: Minneapolis Heart Institute Foundation, Minneapolis, MN.
authors.forename: Raquel
authors.initials: R
authors.lastname: Pereira
authors.affiliation: Minneapolis Heart Institute Foundation, Minneapolis, MN.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Benson
authors.affiliation: Minneapolis Heart Institute Foundation, Minneapolis, MN.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Boucher
authors.affiliation: Minneapolis Heart Institute, Minneapolis, MN.
authors.forename: Thomas
authors.initials: T
authors.lastname: Knickelbine
authors.affiliation: Minneapolis Heart Institute Foundation, Minneapolis, MN.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lindberg
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Marshfield, WI.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: VanWormer
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001795:Blood Pressure Determination / Q000379:methods / Q000706:statistics & numerical data; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000032:analysis*; D015987:Effect Modifier, Epidemiologic; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration; D015397:Program Evaluation; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL