A cluster-randomized trial of blood-pressure reduction in barbershops


The study tested whether pharmacy-led programs in barbershops could lower high blood pressures in African-American men.

"Among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management in barbershops by specialty trained physicians", the authors wrote in the conclusion.

Ciantel Blyler, a clinical pharmacist at Cedars-Sinai Medical Center in Los Angeles and co-author of the study, told CNN that she was "surprised" by the results.

If employed on a broad scale, the approach could make major inroads in treating African-American men, a population that is more likely than other races to have high blood pressure ― a leading risk factor for heart disease and stroke ― and less likely to be in a doctor's care, researchers said.

This disparity is influenced by several factors, including black men's experiences with racism and discrimination, access to health insurance, mistrust for the health care system and social support, the report further detailed. One group of the 303 men in the study received information and tips about managing hypertension, while the other group met pharmacists at the barbershop to receive treatment. That pharmacist would measure the men's blood pressure, encourage lifestyle changes and prescribe blood pressure medication. The culture of trust in barbershops has also made it a critical space for health interventions for black men.

In total, 309 men completed the study-representing a 95 percent cohort retention -and all received an intervention created to help them lower their blood pressure.

According to the CDC, non-Hispanic black people develop high blood pressure more often and at an earlier age than whites and Hispanics. At the end of six months, 64 percent of those who saw a pharmacist had blood pressure in the normal range, compared with 12 percent of those who saw only their barber and were referred to their own doctor. Their systolic blood pressure dropped from 155 mmHg at the start of the study to 145 mmHg after six months.

Trim your hair, your beard, your blood pressure?

"This is a very significant effect for a hypertension trial of any kind", said Victor, whose hypertension was diagnosed by a barber in Dallas during his first barbershop-based study in the 1990s. At the six-month mark, 11.7% of the group brought their blood pressure into the healthy range, the study found. 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.

Victor said trust and rapport is essential because high blood pressure a chronic condition that requires ongoing care and lifestyle changes.

Researchers have started a second phase of the study to determine if the effects are sustained for an additional six months.

Victor also hopes to expand the program to other parts of the country, including African-American men with more moderate blood pressure levels.

The study was funded by a grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health, among other funding sources. The findings were reported in the i New England Journal of Medicine /i and announced Monday at a meeting of the American College of Cardiology.

The ACC's Annual Scientific Session, which is taking place March 10-12 in Orlando, brings together cardiologists and cardiovascular specialists from around the world to share the newest discoveries in treatment and prevention.