Doctors take high blood pressure message to black barbershops
A new study finds that having pharmacists deliver blood pressure care in neighborhood barbershops resulted in lower blood pressure readings for many black men.
"By bringing state-of-the-art medicine directly to the people who need it on their home turf, in this case in a barbershop, and making it both convenient and rigorous, blood pressure can be controlled just as well in African-American men as in other groups", said lead author Ronald Victor, associate director of the Smidt Heart Institute at Cedars-Sinai Medical Center.
Black men have the highest rate of death related to hypertension in the US-coupled with a lower rate of physician interaction and control of hypertension compared to their female counterparts.
The trial randomized 319 patrons in 52 barbershops: 139 with uncontrolled hypertension in 28 shops in the intervention group, for which the barbers promoted follow-up with pharmacists that visited monthly to check blood pressure, prescribe medication, monitor electrolytes, and send notes of progress to primary care providers (PCPs); and 180 in with uncontrolled hypertension in 24 shops in the control group, for which barbers promoted follow-up with PCPs and lifestyle modification.
Each man was assigned either to a control group or to a program, where his barber would recommend that he meet with a trained pharmacist at the barbershop. Men in the first group met with barbers who encouraged them to speak with specially trained pharmacists during their monthly barbershop appointments.
Victor et al. noted one of the limitations of their study is pharmacists targeted blood pressure below 130/80 mm Hg, while primary care providers for control-group participants may have used an in-office goal of 140/90. Six months later, 100 percent of those seen by pharmacists and 63 percent who received only encouragement to see a doctor were taking antihypertensive drugs. "It's a no-brainer that black men are at the highest risk of high blood pressure".
The study was published March 12 in the New England Journal of Medicine and presented at an American College of Cardiology meeting in Orlando, Fla. The corresponding drops in the control group were 9.3 and 4 mm Hg, respectively. In addition, numerous patrons in the trial lived alone, and the authors speculated "peer support at the barbershop facilitated health promotion".
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All the men had high blood pressure, defined as a systolic blood pressure over 140 mm Hg based on multiple measurements taken on two different days.
At baseline, about one-half of participants in both groups were taking blood pressure medication.
Previous studies have shown that equipping barbers-who remain trusted, consistent and convenient influencers for many African-American men-with health information can positively affect health. Dr. Victor has a very honest desire to bring down blood pressure in people in general, and in black men in particular. "The rapport I've been able to establish with this group of patients has been unlike any other I've had in my professional career".
"This is a very large effect for a hypertension trial of any kind", Victor said.
"High blood pressure is a chronic illness that requires a lifetime commitment to medication and lifestyle modification", Victor said.
Researchers have started a second phase of the study to determine if the benefits can be sustained for an additional six months.
The doctor wants to expand his reach by studying 3,000 men in several cities across the country, as well as adding cholesterol screenings into the mix.
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