HONU Comparison Study Press Release

Study Reveals Evidence that Health Initiatives Implemented at a Population Level Can Help Residents Improve Blood Pressure and Cholesterol

Findings published in Preventive Medicine suggest The Heart of New Ulm Project’s initiatives have helped residents lower heart disease risk


MINNEAPOLIS / June 28, 2018: The Minneapolis Heart Institute Foundation® (MHIF) announced today the publication of the latest results supporting its 10-year research project, Hearts Beat Back®: The Heart of New Ulm Project (HONU). This initiative is studying the potential to reduce heart attacks across a community when health initiatives are implemented at a population level. In the study, published in the July issue of Preventive Medicine, MHIF and Allina Health researchers compared several heart disease risk factors for residents of rural New Ulm, Minn., over a six-year period with those for matched residents from another rural Minnesota community. The results showed that New Ulm residents are doing better in controlling their blood pressure, LDL cholesterol, total cholesterol and triglycerides than those in the other community.

Since 2009, MHIF and Allina Health have been conducting the 10-year HONU demonstration project to identify and deliver the best interventions to reduce cardiovascular disease at a population level. HONU has delivered an integrated array of evidence-based interventions in health care, the community and worksites, as well as implemented changes within the community’s food and built environments to support residents in adopting healthier lifestyles. The comparison community did not conduct any sort of similar program during the same timeframe.

“HONU has been a unique research project contributing significant evidence to answer the question of how we can best improve cardiovascular health at a population level,” said Rebecca Lindberg, MPH, MHIF’s director of population health and director for HONU. “Heart disease is the leading cause of death and a major contributor to increasing health care costs around the world. Cardiologists and heart disease prevention organizations such as the American Heart Association have long recognized that in order to effectively reduce heart disease, community-based programs addressing the social, behavioral and environmental determinants of heart disease are needed in addition to clinical care. Yet, limited research is available to identify the most effective community-based strategies. Our researchers have been rigorously tracking and evaluating health improvements in New Ulm for nearly 10 years and to date have published 18 articles in peer-reviewed journals showcasing the project’s outcomes in several different areas. We’re pleased with the results of this latest study that continue to build the strong case that investments in population-level health programs can drive positive changes in health outcomes across a community.”

The study looked at heart disease risk factors and health care utilization among more than 4,000 adults age 40-79 in the New Ulm community from 2009 to 2015 to determine whether trends differed compared to a matching group of adults in a comparison Minnesota community. Since the vast majority of residents from both New Ulm and the comparison community get their care from Allina Health, the study was able to monitor these measures through electronic health record data.

Blood pressure: Specifically, the study results showed that while the proportion of people with their blood pressure under control increased by 6.2 percentage points in New Ulm, the comparison community only showed an increase of 2 percentage points. Researchers concluded that because the number of people taking blood pressure medication in both communities was similar, the considerably larger blood pressure improvement in New Ulm may be a result of HONU programs and activities that helped people make lifestyle changes.

Cholesterol: The proportion of people with their cholesterol at goal (< 200 mg/dL) decreased by 1 percentage point in New Ulm over the six years as the cohort got older, compared to a significantly larger 8 percentage-point decline in the comparison community. As people age, cholesterol levels tend to rise. However, this study found that those in New Ulm had very little increase in average cholesterol values over the six years (0.4 mg/dL), while those in the comparison community had an average increase in their cholesterol values of 6.5 mg/dL.

“These results, showing improved management of heart disease risk factors in the HONU community, provide good news from a population health research perspective,” said Abbey Sidebottom, PhD, MPH, a principal scientist for Care Delivery Research at Allina Health and one of the authors on the article. “HONU is a great example of how an entire population can lower their risk for heart disease. Many people making small changes can have a greater impact on the rate of heart attacks than a few people making great changes.”

An earlier study that compared HONU’s six-year results with data on a national level from the National Health and Nutrition Examination Survey (NHANES) showed that New Ulm’s improvements in total cholesterol, blood pressure and blood glucose are also better than the rest of the country.

“Health care leaders across the country often ask me about the financial investment we have made in HONU, and whether we have the outcome data to prove its worth,” said Toby Freier, president of Allina Health’s New Ulm Medical Center. “We do have the data showing positive outcomes. This study provides strong evidence in support of a comprehensive package of interventions, such as we’ve done through HONU, for lowering heart disease risk, particularly for blood pressure, cholesterol and triglycerides.”

“One of our goals with The Heart of New Ulm Project has been to create a model for improving health that can be replicated in other communities, especially rural communities, and we’re excited that our experience and results in New Ulm can help guide other communities and health care organizations as they partner to improve the health of their population,” said Lindberg.

The journal article, “Assessing the Impact of The Heart of New Ulm Project: A Population-Based Program to Reduce Cardiovascular Disease,” is available online.

About HONU

Started in 2009, Hearts Beat Back®: The Heart of New Ulm Project is a 10-year population-based prevention demonstration project designed to reduce the number of heart attacks that occur in New Ulm, Minn. The project is a collaborative partnership of the Minneapolis Heart Institute Foundation, Allina Health and the New Ulm community that employs evidence-informed health improvement practices in community settings, health care, worksites, and the food and built environments.

About the Minneapolis Heart Institute Foundation®

The Minneapolis Heart Institute Foundation (MHIF) strives to create a world without heart and vascular disease. To achieve this bold vision, it is dedicated to improving the cardiovascular health of individuals and communities through innovative research and education.

  • Scientific Innovation and Research — MHIF is a recognized research leader in the broadest range of cardiovascular medicine and population health initiatives. Each year MHIF leads more than 175 active research projects and publishes more than 175 peer-reviewed abstracts. Cardiologists, hospitals and communities around the world adopt MHIF protocols to save lives, improve care and create healthier living opportunities.
  • Education and Outreach — MHIF provides more than 10,000 hours of education each year putting its research into practice to improve outcomes. And, MHIF leads cutting-edge, transformative population health research to connect, engage, inform and empower individuals and communities to improve their health.

The Minneapolis Heart Institute Foundation’s work is funded by generous donors and sponsors and supports research initiatives of Minneapolis Heart Institute® at Abbott Northwestern Hospital. Minneapolis Heart Institute® physicians provide care for patients at Abbott Northwestern Hospital in Minneapolis and at 38 community sites across Minnesota and western Wisconsin. More information can be found at https://mplsheart.org

About Allina Health
Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 15 retail pharmacies, specialty care centers and specialty medical services, home care, home oxygen and medical equipment and emergency medical transportation services.