Source Scientific American

The town of New Ulm, Minn., some 90 miles outside of Minneapolis, is small. With a population of about 15,000, the self-proclaimed polka capital of the U.S. might not seem like the most obvious locale to roll out an aggressive, unconventional attack on heart disease.

But for the past couple years, a local health system has been doing just that, using an array of preventive health tactics that include everything from state-of-the-art electronic health records to free water aerobics classes.

Early results suggest that the preventive health program has been working. In the some 10,000 adults in the target zip code (56073), the rate of acute heart attacks fell by 24 percent in 15 months, according to research presented this week at the American College of Cardiology meeting in New Orleans. Fewer than 50 people in the area suffered a heart attack in 2008—before the reduction efforts kicked in—so the stats are slight, but the approach could have implications for larger population bases.

The program “encourages a large population to embrace healthy lifestyle changes, such as smoking cessation and improved nutrition that could improve long-term health,” Jackie Boucher, of the Minneapolis Heart Institute Foundation, said in a prepared statement. Area residents can join an organized walking group, take a cooking class or participate in workplace health screening. 

Rather than relying on a government grant, the community-driven project is supported by the region’s healthcare system—along with help from local employers and organizations—Boucher said. Most residents are served by the New Ulm Medical Center, which is run by Allina Hospitals & Clinics, a not-for-profit regional system with a 2010 operating revenue of $3.1 billion. This business-backed model might become more common as government programs see their budgets shrink. Although the initiative has been pegged at about $40 million, it could help cut medical costs in the long run. In 2010, treating heart disease in the U.S. cost about $272.5 billion—a price tag that is expected to triple by 2030.

Before the interventions began, researchers found that some 36 percent of New Ulm residents had metabolic syndrome—and 73 percent were overweight or obese. To help combat these steep cardiovascular risk factors, the healthcare system used another robust local statistic: more than 90 percent of people there have an Allina electronic health record, “which serves as a helpful surveillance database,” Boucher said. So doctors were able to start quickly pinpointing individuals who were at high risk for a heart attack and help them better track their health by monitoring cholesterol, blood pressure and medication.

With a goal of cutting heart attacks down the zero, the program aims to get residents out of that high-risk category in the first place by helping them make key lifestyle changes. “Preventive care is the number one factor responsible for reducing cardiovascular mortality in the United States over the past 20 years,” Thomas Knickelbine, a cardiologist at the Minneapolis Heart Institute, said in a prepared statement.

And by in large the locals seemed willing to participate. Some 5,198 adults were screened for the program in 2009, and more than 1,000 people attended at least one related community health event, such as a workplace seminar or activity.

The project might “serve as a model of how healthcare systems can implement population-based [chronic heart disease] prevention programs to improve associated healthcare costs, quality and patient experiences,” the researchers noted in a summary of their study.

And the group has plans to continue assessing the program’s progress for a full decade. No word, however, on whether the town’s famous Oktoberfest has switched to turkey brats.