A cluster-randomized trial of blood-pressure reduction in barbershops

For African-American men with uncontrolled hypertension, health promotion by barbers led to greater blood-pressure reduction when combined with medication management in barbershops by specialty-trained pharmacists, according to new research.

For African-American men with uncontrolled hypertension, health promotion by barbers led to greater blood-pressure reduction when combined with medication management in barbershops by specialty-trained pharmacists, according to new research. The findings were reported in the <i>New England Journal of Medicine</i> and announced Monday at a meeting of the American College of Cardiology. Uncontrolled hypertension is a significant problem among non-Hispanic black men, the researchers note. The study enrolled more than 300 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops for a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention or to an active control approach. For the intervention, barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy, while the active control approach had barbers encourage lifestyle modification and doctor appointments. At 6 months, the mean systolic blood pressure dropped by 27.0 mm Hg (to 125.8 mm Hg) in the intervention group and by 9.3 mm Hg (to 145.4 mm Hg) in the control group. The mean reduction was 21.6 mm Hg greater with the intervention. In all, 63.6% of the intervention group achieved a blood-pressure level of less than 130/80 mm Hg, compared with 11.7% of the control group. The rate of cohort retention in the intervention group was high (95%), and there were few adverse events. The researchers note that sustainability beyond 6 months is being considered in ongoing extension study. "Several aspects of our intervention (blood-pressure measurement and medication protocols) could be adopted by other health care professionals and organizations," they write. "We believe that the relatively large intervention effect indicates that such implementation research is warranted."