Marianna Examination Survey on Hypertension (MESH)

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Marianna Examination Survey on Hypertension
(MESH)
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Overview

• MESH Background
• Results
• The study population
• The findings
• Summary
• Conclusion and Follow-up
• Questions and Answers

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Mesh background

• Why
• Developed and funded in 2005 by the Arkansas
  Minority Health Commissions Hypertension Program
• Needed information on undiagnosed high blood
  pressure and diabetes in Arkansas
• How severe?
• How well controlled?
• Same questions could be asked for diabetes,
  cholesterol and other heart disease risk factors

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• What
• Population based, representative, examination
  survey
• Very difficult to do, requires a lot of planning
  and effort
• Population based because the careful procedures
  we used mean that we talk about the entire
  community
• Representative meaning that we have included all
  portions of the community
• Examination means that we can detect undiagnosed
  and poorly controlled high blood pressure

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Mesh background

• Who
• Adult residents within the city of Marianna
• Marianna chosen because
• Similar to many small cities in Eastern Arkansas
  (age, gender, education, income)
• Your leaders were very supportive

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• How
• Developed a list of all residential addresses
• Chose 1200 addresses to be approached
• At each household, asked household member to list
  all adults. Randomly chose one adult to
  participate
• Detailed questionnaire (39 pages), examination,
  blood and urine samples for analysis
• Able to DETECT high blood pressure because it was
  measured at two visits
• Glucose, hemoglobin A1C, cholesterol,
  triglycerides, HDL, creatinine, cystatin C,
  hemoglobin, CRP, urine albumin, urinalysis

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Methodology

• Initial goal was to enroll 800
• Total 453 participants enrolled over a two year
  period. More than 10 of adult population. More
  than 80 power to detect a 3 difference in
  percent with high blood pressure
• High blood pressure defined as ever being told
  you had high blood pressure, and/or average
  measured blood pressure gt 140/90

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Todays presentation

• First look at the data
• More detailed analyses will be done later.
• You as community members will help shape these
  analyses with your questions and insight.
• Knowledge is power.

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The Study Population

• Sample of the adult population within the city
  limits of Marianna
• 453 completed surveys and 273 labs
• 351 Females (77)
• 396 African American (87)

Age Group
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The Findings

• Preliminary survey data
• Organization of the data
• Hypertension and Diabetes in the community
• Risk factors in the population
• Access to health care
• Knowledge of heart attack and stroke sign

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The Findings

• Hypertension and Diabetes in the community
• Risk factors in the population
• Access to health care
• Knowledge of heart attack and stroke sign

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have you ever been told by a doctor that you
have diabetes or sugar diabetes?
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Yes, have been told by a doctor that you have
diabetes or sugar diabetes? by age
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About how many times in the past 12 months has
a doctor, nurse, or other health professional
checked you for hemoglobin a one c?
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No, have not had a1c in the last 12 MOnths by
age
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have you ever been told by a doctor, nurse or
other health professional that you have high
blood pressure?
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Yes, have been told by a doctor, nurse or
other health professional that you have high
blood pressure? by gender
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Yes, have been told by a doctor, nurse or
other health professional that you have high
blood pressure? by age
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TAKING PRESCRIBED MEDICINE?
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TAKING Not taking prescribed medicine for
high blood pressure? by age
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Hypertension in Marianna
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Percent of adults taking medicine for high blood
pressure, whose blood pressure is not controlled

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Percent of adults with diagnosed and undiagnosed
high blood pressure (BP gt 140/90)
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The Findings

• Hypertension and Diabetes in the community
• Risk factors in the population
• Access to health care
• Knowledge of heart attack and stroke sign

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Have you ever had you blood cholesterol
checked?
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Never had your blood cholesterol checked
by gender
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Never had your blood cholesterol checked by
race
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Never had your blood cholesterol checked by
age
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have you ever been told by a doctor, nurse, or
other health professional that your blood
cholesterol is high?
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Yes, have been told by a doctor, nurse, or
other health professional that your blood
cholesterol is high? by age
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Current smokers
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Current smoking by age
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Seeing dentist
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Overweight and obesity
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Overweight and obesity by gender
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Overweight and obesity by age
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The Findings

• Hypertension and Diabetes in the community
• Risk factors in the population
• Access to health care
• Knowledge of heart attack and stroke sign

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Do you have any kind of health care coverage?
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Health care coverage by age
Age Group
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Was there a time in the last 12 months
when you needed to see a doctor, but could not
because of the cost?
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Could not see a doctor, because of the
costby race
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Was there a time in the last 12 months when you
needed to get a prescription filled, but could
not because of the cost?
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Could not get a prescription filled, due to
Cost by race
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how long has it been since you last visited a
doctor for a routine checkup?
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The Findings

• Hypertension and Diabetes in the community
• Risk factors in the population
• Access to health care
• Knowledge of heart attack and stroke sign

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Signs and symptoms of heart attack

• Pain or discomfort in the jaw, neck, or back
• Feeling weak, lightheaded, or faint
• Pain or discomfort in the arms or shoulders
• Shortness of breath

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Signs and symptoms of stroke

• Sudden confusion or trouble speaking
• Sudden numbness or weakness of face, arm, or leg,
  especially on one side
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of
  balance
• Severe headache with no known cause

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Know all signs and symptoms of Heart Attack and
Stroke
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Summary of Data

• Increased prevalence of Hypertension and Diabetes
  in the community
• Large proportion of the population with risk
  factors for chronic diseases
• We know they may know but not controlled
• Not getting appropriate recommended screening
• May have to do with cost and access

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Conclusion

• Importance of MESH Study
• Can be used by the community to both ask further
  questions
• Can be used to help develop programs or
  interventions to improve health
• Follow community cardiovascular health health
  overtime
• This supports the long-term goal of decreasing
  both heart attack and stroke deaths in the
  community

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The Follow-Up

• You have seen preliminary data
• We are continuing the analysis
• Analysis of the lab data
• AMHC have a commitment to the community
• Define further questions with community
• Develop program or intervention
• Develop Community Advisory Committee for further
  data use and planning

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Special thanks

• Lee County Health Unit
• Lee County Clinic
• Marianna Water and Sewer Department
• Marianna Post Office
• Marianna Housing Authority
• UPS

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Percent were you told on 2 or more different
visits that you had high blood pressure or
hypertension?