Helping Young Adults Manage High Blood Pressure

Overview

To prevent heart disease and stroke among young adults, we have increased young adults’ skills in managing their high blood pressure through the MyHEART clinical program currently being tested in two large Wisconsin health systems, UW Health and Aurora Health Care. In addition to the MyHEART clinical program, there have been 17,506 visits to the MyHEART public website with 26,100 page views.

The Clinical Problem

Approximately 1 in 15 young adults in the United States have high blood pressure, but young adults have the lowest rates of blood pressure control (achieving a blood pressure <140/90 mmHg) compared to other adult age groups.

Prolonged high blood pressure increases young adults’ risk of a future heart attack, stroke, congestive heart failure, and/or kidney disease. However, many young adults have reported having few resources to address their needs for heart health education.

“We know that hypertension control in young adults is a tremendous benefit not only to their health and longevity but also for reducing healthcare costs,” says Dr. Heather Johnson, associate professor of cardiovascular medicine at the University of Wisconsin – Madison.

“When we worked with diverse focus groups of young adult hypertension patients and their providers, we found that brochures about blood pressure management weren’t making it past the waiting room recycle bins,” says Dr. Johnson. “If the brochure showed a picture of someone who was perceived as older than themselves, or if they felt it didn’t offer new information, they would discard it.”

Our Response

To address these problems, the MyHEART program was developed with young adults and healthcare team members to address a broad range of topics.

MyHEART stands for the My Hypertension Education and Reaching Target program, and its goal is to share information with young adults to help them live a healthier life, lower their blood pressure, and prevent heart disease.

“We need to empower young adults learning about healthy lifestyle changes by providing evidence-based information in a way that’s convenient and accessible to them, not in a format that makes them feel powerless or older than their age.” — Heather Johnson, MD, MS, Associate Professor of Cardiovascular Medicine, UW-Madison

MyHEART has multiple components, including young adult education and research programs across multiple healthcare systems.

MyHEART Research Program

The MyHEART research program focuses on increasing young adult self-management skills to promote heart healthy choices and lower blood pressure. It is a theoretical based health coaching program tailored to young adults with hypertension, and includes four evidence-based self-management components:

1. Telephone-based health coaching with adult education specialists to teach and monitor self-management skills
2. Electronic health record documentation of coach-patient telephone contacts
3. Individualized hypertension education materials
4. Home blood pressure monitoring

A study funded by the National Heart, Lung, and Blood Institute is currently being led by Dr. Johnson at locations in the Madison and Milwaukee, Wisconsin areas to determine the impact of the MyHEART program on blood pressure. Young adults interested in participating in the study can find more information about it here.

MyHEART Educational Website

Through a grant from the UW Institute for Clinical and Translational Research, Dr. Johnson worked with UW faculty and staff to develop the MyHEART website, as well as Twitter and Facebook accounts. These online resources offer information about how to check and monitor blood pressure (My Heart), evidence-based actions for stress management, diet, exercise, and avoiding tobacco and alcohol (My Choice), and resources for successful hypertension management (My Support).

The MyHEART website content was developed in response to focus groups comprised of young adults with hypertension (45% Black) and one-on-one interviews of primary care providers in academic, urban, and rural Wisconsin healthcare systems.

The Wisconsin Network for Research Support (WINRS) and their lay advisory group, the Community Advisors on Research Design and Strategies (CARDS®), partnered with the MyHEART team to enable cycles of usability tests and revisions prior to launch of the web site.

Lasting Impact

The results of the MyHEART research study will address an unmet need to develop evidence-based interventions that improve hypertension control in young adults. Study results will be published in peer-reviewed journals and disseminated broadly so that other young adults across the country can benefit from the research.

The MyHEART team is working in collaboration with partners both within Wisconsin and nationally to conduct iterative marketing cycles of the MyHEART website and social media accounts. A Spanish-language version and additional interactive elements are planned for the MyHEART site in the future.

“The MyHEART web site is another tool that patients and providers can use to help young adults get the information they need to live longer and healthier lives.

It also complements other aspects of the MyHEART primary care coach intervention which includes telephone-based self-management counseling, home blood pressure monitoring, and electronic health record documentation of coach-participant telephone contacts.” — Heather Johnson, MD, MS, Associate Professor of Cardiovascular Medicine, UW-Madison

Additionally, a free toolkit for clinicians, health care administrators, and other health advocates who are interested in using the MyHEART website within their organization is also available. It contains information and tools for promoting the use of MyHEART website, including posters, brochures, and sample social media and website posts.

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