1. Marianna Examination Survey on Hypertension (MESH)

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

3. Mesh background • Why • Developed and funded in 2005 by the Arkansas Minority Health Commission’s 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

4. Mesh background • 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

5. 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

6. Mesh background • 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

7. 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 > 140/90

8. Today’s 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.

9. 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

10. 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

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

12. have you ever been told by a doctor that you have diabetes or sugar diabetes?

13. Yes, have been told by a doctor that you have diabetes or sugar diabetes? – by age

14. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for hemoglobin “a one c”?

15. No, have not had a1c in the last 12 MOnths– by age

16. have you ever been told by a doctor, nurse or other health professional that you have high blood pressure?

17. Yes, have been told by a doctor, nurse or other health professional that you have high blood pressure? – by gender

18. Yes, have been told by a doctor, nurse or other health professional that you have high blood pressure? – by age

19. TAKING PRESCRIBED MEDICINE?

20. TAKING Not taking prescribed medicine for high blood pressure?– by age

21. Hypertension in Marianna

22. Percent of adults taking medicine for high blood pressure, whose blood pressure is not controlled

23. Percent of adults with diagnosed and undiagnosed high blood pressure (BP > 140/90)

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

25. Have you ever had you blood cholesterol checked?

26. Never had your blood cholesterol checked – by gender

27. Never had your blood cholesterol checked– by race

28. Never had your blood cholesterol checked – by age

29. have you ever been told by a doctor, nurse, or other health professional that your blood cholesterol is high?

30. Yes, have been told by a doctor, nurse, or other health professional that your blood cholesterol is high?– by age

31. Current smokers

32. Current smoking – by age

33. Seeing dentist

34. Overweight and obesity

35. Overweight and obesity–by gender

36. Overweight and obesity –by age

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

38. Do you have any kind of health care coverage?

39. Health care coverage by age Age Group

40. Was there a time in the last 12 months when you needed to see a doctor, but could not because of the cost?

41. Could not see a doctor, because of the cost–by race

42. Was there a time in the last 12 months when you needed to get a prescription filled, but could not because of the cost?

43. Could not get a prescription filled, due to Cost – by race

44. how long has it been since you last visited a doctor for a routine checkup?

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

46. 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

47. 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

48. Know all signs and symptoms of Heart Attack and Stroke

49. 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

50. 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