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Hearts Beat Back

Key Message

Population health program significantly decreases heart disease risk factors across an entire community. 


Sidebottom, Abbey C. et al. (2016). 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. American Heart Journal.175:66-76. DOI:


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.

Hearts Beat Back: The Heart of New Ulm Project (HONU) focuses on reducing factors known for increasing heart attack risk, including high cholesterol, high blood pressure, uncontrolled glucose, obesity, tobacco use, physical inactivity, low fruit and vegetable intake, and medication underutilization/non-adherence. HONU deploys evidence-based initiatives through many venues in the community, including health care settings, worksites, restaurants, and community spaces and events including farmers markets and concession stands.


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/m2 (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%.

Benefit Statements / Outcomes

Leadership Provided By:

  • Leisure Information Network (LIN)
  • Alberta Recreation and Parks Association

On Behalf Of:

  • Canadian Parks and Recreation Association (CPRAA)

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