Ingrid Lindquist, Joshua Brown MD, Christopher Bunn DO
Introduction and background
Hypertension is the most common modifiable risk factor of premature cardiovascular disease and events. One in three American adults have hypertension and about half of those with a formal diagnosis do not have it controlled. A major challenge in reducing the prevalence of hypertension is that it is a chronic, progressive and asymptomatic condition. While hypertension is a serious medical condition, there are well-defined and effective ways to monitor and control it with medical and lifestyle interventions. Therefore, improving early detection efforts and access to and use of medical care has the potential to considerably reduce the rate of hypertension and its consequences.
According to state cause-of-death records, New Mexicans under the age of 75 have increased mortality due to hypertension relative to national rates, most notably in Hispanic and Native American men. We hypothesize that limited access to primary care is a significant factor leading to this and other health disparities in the state.
Current estimates of hypertension and cardiovascular disease burden in northern New Mexico are limited to data collected from national surveys like the Behavioral Risk Factor Surveillance System, hospital records and state death records. These epidemiological estimates have been found to underestimate disease burden in communities, particularly those with significant minority populations. Thus, improved community-specific disease burden assessments are necessary to accurately determine risk and can profoundly impact the resources allocated to at-risk communities.
Community blood pressure screening has been utilized as a public health strategy for decades. Recent studies on this method of intervention found that public screening coupled with direct medical referral is most effective in improving blood pressure control. In order to facilitate a reduction in cardiovascular risk, a clear route to medical follow-up is vital.
We present our efforts in a community blood pressure screening, education and medical referral program called Impact Heart Health (IHH), a collaborative quality improvement (QI) community health project with the non-profit Impact Health New Mexico in Santa Fe, NM.
Methods and Results
To date we have screened 380 individuals for high blood pressure at 28 community events primarily in Santa Fe, providing individuals with heart health education and medical referral. In addition to direct services to community members, we evaluate the rates of hypertension in the community as well as risk factors of smoking history and access to primary care. Up-to-date results will be presented at the ACP conference.
Conclusions
We present the structure of our ongoing community program as a successful model of community engagement and community-based participatory research in northern New Mexico that includes disease screening, health education, medical referral and assessment of risk factor burden.