Medical Intervention in Barbershops Effective for BP Reduction
Black men with uncontrolled hypertension experienced a larger reduction in blood pressure through health promotion by barbers in combination with medication management in barbershops by specialty-trained pharmacists, according to a study presented at ACC.18 Scientific Sessions & Expo.
For this cluster-randomized trial, 319 black male customers with systolic blood pressure (BP) ≥140mmHg across 52 barbershops in Los Angeles County were included. Barbershops were assigned to a pharmacist-led intervention or to an active control approach. A pharmacist-led intervention referred to barbers encouraging meetings in barbershops with specialty-trained pharmacists who prescribed medications under a collaborative practice agreement with the participants' doctors. An active control approach referred to barbers encouraging lifestyle modifications and doctor appointments. The primary outcome was a decrease in systolic BP at 6 months.
Mean systolic BP at baseline was 152.8mmHg and 154.6mmHg in the intervention and control groups, respectively. Participants ranged from 35 to 71 years old and had frequented their barbershop on average for over 10 years and received haircuts twice a month.
The results showed that at 6 months, there was a 27.0mmHg reduction in the intervention group vs a 9.3mmHg reduction in the control group. The intervention arm saw a 21.6mmHg greater reduction (95% CI: 14.7 to 28.4; P<0.001) vs the control arm. More than half of the subjects in the intervention group (63.6%) achieved a BP <130/80mmHg compared with 11.7% of subjects in the control group (P<0.001).
The use of antihypertensive medications increased from 55% to 100% in the intervention group and from 53% to 63% in the control group (P<0.001). Those in the intervention group were also more likely to be treated with long-acting agents such as amlodipine, irbesartan or telmisartan, and indapamide, vs those in the control group.
The authors also reported a cohort retention rate of 95% in the intervention group with 309 men completing the study. No treatment-related serious adverse events were reported in either arm.
"In conclusion, medication management that was delivered in barbershops by specialty-trained pharmacists, as compared with standard management afforded by primary care practices, resulted in much larger blood-pressure reductions in black male patrons of those shops who had hypertension," said lead author Ronald G. Victor, MD, associate director of the Smidt Heart Institute at Cedars-Sinai.
Victor RG, Lynch KL, Li N, et al. A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops. Presented at: ACC.18 Scientific Sessions & Expo. March 10–12, 2018; Orlando, FL. Abstract #408-12. http://www.abstractsonline.com/pp8/#!/4496/presentation/41754