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Mar 26, 2018

Treating High Blood Pressure in Black Barbershops

Los Angeles study shows on-site pharmacists promote better blood pressure management.

Delivering health care in barbershops could help eliminate health disparities, based on a recent study that linked an on-site pharmacist at barbershops to improved blood pressure control in black men.

Presented at the American College of Cardiology’s 67th Annual Scientific Session and published in the New England Journal of Medicine, this study tested a blood pressure intervention in Los Angeles barbershops. The goal was to see whether making treatment more convenient could improve blood pressure control in black men.

High blood pressure currently affects one in three U.S. adults, but occurs more often and at an earlier age in African-Americans.

The study took place over a six-month period at 52 barbershops in Los Angeles County. It included 319 black men between the ages of 35 and 71, all of whom had high blood pressure based on barbershop-based screenings.

Participants were regular patrons of the barbershops—visiting for a haircut at least once every six weeks.

During the study, half of the barbershops were randomly chosen for a pharmacist-led intervention. At those sites, barbers were trained to encourage treatment, and on-site pharmacists met regularly with participants to prescribe medications and monitor blood pressure. Pharmacists also kept in contact with participants’ doctors, providing progress notes after each meeting.

The other half of barbershops served as controls, where barbers were only trained to discuss information about high blood pressure and encourage follow-up with a provider.

After six months, researchers found that the pharmacist program significantly improved blood pressure control among study participants. The average systolic blood pressure fell by 27 mmHg in the intervention group, compared to just 9 mmHg in the control group. By the end of the study, 64% of men in the intervention group had achieved an ideal blood pressure level, compared to just 12% of the control group.

Part of the reason the intervention was so successful was that it helped connect patients with the treatment they needed. At the start of the study, only one-half of participants in both groups were taking at least one medication for high blood pressure. After just six months, 100% of men in the intervention group were taking at least one medication, compared to 63% of the control group.

Findings are promising, as blacks face disproportionately high rates of blood pressure, which increases risk for heart attack and stroke.

“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,” explains Ronald G. Victor, MD, lead author of the study. “If this model was scaled up and sustained, millions of lives could be saved, and many heart attacks and strokes could be prevented.”

The future plan for this study, according to authors, is to track study participants for an additional six months. They hope to see how long the program’s effects last and track its impact on outcomes like heart attack and stroke.

Questions for You to Consider

  • What are health disparities?
  • Health disparities refer to differences in health outcomes or burdens of disease between groups of people. Health disparities can exist between different populations of race, sex, income, or even geographic location. In health care, the goal is to eliminate these differences so all individuals have the same ability to achieve good health.
  • What is hypertension?
  • Hypertension, often referred to as high blood pressure, occurs when the force of blood against the artery walls is too high. High blood pressure is often referred to as the “silent killer,” because it often causes no symptoms and if left uncontrolled, increases risk for heart attack and stroke.

Infographic: High Blood Pressure

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