A new study published Monday in the New England Journal of Medicine offers a clear reminder that you can do a lot of good by meeting people where they are, in where you would like them to be. He discovered that a health program organized through barbershops was very effective in helping non-Hispanic black men reduce their blood pressure.
Researchers in Los Angeles hired more than 50 black-owned hairdressers to participate in a randomized experiment for nearly two years.
Barbers were trained to take blood pressure from interested clients, and to push those with hypertension to consult a doctor and to eat healthier and become more active. But 28 barbershops were also asked to recommend that their clients meet periodically with a specially trained pharmacist who would prescribe or adjust their blood pressure medications for a period of six months (the pharmacist would confirm with a doctor that insurance).
Often, the pharmacist even met with the patient in the barbershop for his check-up. These hairdressers supported by pharmacists, unlike the control group, would also have posters on the wall that would detail authentic stories of previous patients who enjoyed participating in the study, known as "Cut Your Pressure Too: The Barbershop Blood Pressure Study".  In total, 319 black men between 35 and 79 years with high blood pressure were enrolled in the study from 2015 to 2017. On average, their systolic blood pressure (the number on the top that measures how difficult it must be to contract our heart while hitting) was 152 milligrams per mercury or mm of HG. Both groups saw a significant fall in blood pressure within six months, but those in the group led by pharmacists (132 volunteers) saw a large decrease of 27.00 mm HG on average, compared to the 9.3 mm HG seen with the control group (171 volunteers). And almost two-thirds of the group led by pharmacists had their general blood pressure below 130/80 mm HG (the ideal healthy reading is 120/70 mm hg).
"Taking rigorous medications directly to men in a barbershop, and making it so convenient for them, really made a difference," said lead author Ronald G. Victor, a cardiovascular physician at Cedars Sinai Medical Center and a professor at UCLA, a Los Angeles Times .
Hairdressers have been touted as a possible way of raising health awareness among black men for years, as they are a constant and reliable presence in the neighborhood (many in the studio had visited their barbers every two weeks during one of each) . Men in general are less likely to visit the doctor than women, while more than 40 percent of black men, in particular, have high blood pressure, the highest of any racial or ethnic group among men. Black men are also less likely to have their hypertension controlled and have the highest mortality rate related to hypertension of any population group.
Victor and his team in fact published a similar random barber study in 2011, which found modest improvements in those who were regularly monitored for blood pressure and encouraged to stay healthy. But the new test is the first to combine drug therapy along with the positive message. And the drastic improvements – more than double what Victor and his team had anticipated – suggest that it is worth developing an expanded barbershop program across the country.
Victor and his team are studying volunteers over the past six months to see how long the changes last.
[NEJM via Los Angeles Times]