Los Angeles—More than hair got trimmed at barbershops where African-American men were able to meet monthly with pharmacists. Their systolic blood pressured dropped by 21 mmHg more, on average, than other men who simply were encouraged by their barbers to follow up with a physician and make healthy lifestyle choices.

Results of the study conducted over a 6-month period in Los Angeles were revealed at the American College of Cardiology’s 67th Annual Scientific Sessions in Orlando, Florida. They also were published simultaneously in the New England Journal of Medicine.

Background information in the report notes African-American men are more likely than other groups to have high blood pressure that is not adequately controlled, which is a problem because that cohort also tends to have less contact with the healthcare system.

“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,” explained lead author Ronald G. Victor, MD, associate director of the Smidt Heart Institute at Cedars-Sinai. “If this model was scaled up and sustained, millions of lives could be saved, and many heart attacks and strokes could be prevented.”

While previous studies have shown that barbers, as trusted, consistent and convenient influencers for many African-American men, can help their customers improve health, this research was different because it compared that approach with healthcare delivery from a pharmacist and evaluated the efficacy with a randomized trial.

Researchers recruited 319 customers, all of whom had systolic blood pressure over 140 mmHg based on multiple measurements taken on 2 different days, from 52 Los Angeles County barbershops. The men, aged 35 to 71 years, had been patronizing their barbershops for more than a decade, on average, and had their hair cut twice a month.

“The two major strengths of the study are the large reduction in blood pressure itself and the high cohort retention,” noted Victor, pointing to a 95% cohort retention rate with 309 men completing the study.

Slightly more than half the participants were randomly assigned to receive health education from barbers trained to use a National Heart, Lung, and Blood Institute–developed script to encourage the men to visit their doctors and get their blood pressure under control.

A pharmacist met at the barbershops with the remaining men, who were randomly assigned to receive regular monitoring at least once a month and ongoing medication management. That group’s participants received a blood pressure evaluation and a finger-stick blood test during each visit from the specially trained pharmacist, who used the information to evaluate each man’s response to blood pressure medications and to adjust prescriptions as needed, under a collaborative-care agreement with primary care physicians.

Results indicate that the men who only interacted with their barber and were referred to their own doctors had systolic blood pressure declines from an average of 155 mmHg at the start of the study to an average of 145 mmHg after 6 months. At the same time, diastolic blood pressured dropped by 4 mmHg in that group.

Men interacting with their barber and a pharmacist had much greater blood pressure declines, however. Their systolic blood pressure fell from 153 mmHg at the start of the study to 126 mmHg after 6 months, while their diastolic blood pressure went down.

In fact, after 6 months, 64% of the participants interacting with the pharmacist had normal blood pressure as defined by current ACC/American Heart Association guidelines; just 12% who saw only their barbers reached the same level.

“This is a very large effect for a hypertension trial of any kind,” Victor said. “We are very excited about the results.”
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