MONDAY, Dec. 17, 2018 (American Heart Association) -- Barbershops in the African-American community could help men reduce and control their blood pressure, according to a new study.
The research showed long-term reductions in blood pressure among customers who met periodically with pharmacists at 52 Los Angeles County barbershops. Published Dec. 17 in the American Heart Association journal Circulation, the study spanned a total of 12 months and followed up a six-month study published early this year in the New England Journal of Medicine.
"There is something special about meeting people on their turf. It changes the power dynamic between the health care professional and the patient," said Dr. C. Adair Blyler, one of the study's lead authors and one of two pharmacists who visited the barbershops. "A lot of these men have a real mistrust for the medical profession, but they trust their barbers. The barbers' endorsement was critical to our success."
Barbers introduced their long-time customers to an on-site pharmacist, who tested patrons' blood pressure. If the pressure was above 140/90 -- a figure considered high -- the pharmacist prescribed blood pressure medicine in collaboration with the customer's primary care physician.
Compared to a control group, the men who met with a pharmacist and received medication showed "a large and sustained blood pressure reduction" over 12 months, with an average drop of 28.6 millimeters of mercury, or mmHg. Almost 70 percent of the men hit their target goal of less than 130/80.
According to the most recent guidelines, high blood pressure is when the systolic number (the top one in the measurement) is 130 or above or the diastolic (bottom number) is 80 or above.
The most recent results were achieved with less visits by pharmacists than in the original six-month study, Blyler said.
"We showed we could sustain the impressive blood pressure results even after we scaled back the interactions between pharmacists and patients," she said. "If we can continue to increase efficiency, this could be a cost-effective model we can implement nationwide."
High blood pressure rates for African-Americans in the United States are among the highest in the world, with 46 percent of men and 45 percent of women having the condition. High blood pressure increases the risk of heart disease and stroke and can cause permanent heart damage even before a patient notices any symptoms.
Xavier Chavis said the program was "a great idea" to involve men like him, who often don't like going to the doctor. After meeting with a pharmacist, he switched to a different medicine that lowered his blood pressure more.
"If they're just sitting at a barbershop waiting to get their hair cut, they might as well get their blood pressure checked, too," said Chavis, 50, of Compton, in southern Los Angeles County. "It's a wonderful program because it goes to the people instead of waiting for the people to come to them."
Blyler said having highly paid pharmacists spending hours driving to barbershops could ultimately be too expensive. She's now conducting a study in which pharmacists conduct follow-ups remotely, via video conferencing. She said she'd like to see future studies targeting African-American women in beauty shops.
But the study's promise far outweighs its logistical roadblocks, said Dr. Clyde Yancy, chief of cardiology at Northwestern University's Feinberg School of Medicine in Chicago.
"It's an ingenious and potentially disruptive study that makes a very strong case that going into the community works," said Yancy, who was not involved in the study.
"In my mind, I see many more opportunities than challenges: Who else besides the barbershop is a trusted resource? Is it the fire station? The school? Let's continue thinking cleverly about how we can come up with models that are more accessible and more responsive to the patient's environment."
The study is the culmination of years of work by Dr. Ronald G. Victor, a hypertension researcher who died Sept. 10 of pancreatic cancer. Victor conducted his first study of blood pressure in black barbershops in 2006.
"This study says a lot about his character and how important he perceived this problem to be," said Yancy, a colleague of Victor. "He was a Jewish man -- not the first person you would have thought would go into the African-American community and become a champion for this. And even when he knew he was dying, he kept working fervently to create a path forward for people he will never know but who could greatly benefit from his work. I consider him a hero of heart disease."
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