Healthcare given by a pharmacist in the local barbershop
- Blood pressure can be effectively controlled by a
intervention in an informal non-clinical setting by at the
local barbershop in African-American patients
- African-American men are at highest risk of high blood
pressure and associated complications such as heart attack and stroke, due
to lesser physician interaction
has been found to effectively lower high blood pressure in African
American patients, according to a recent study conducted by Smidt Heart Institute.
The findings of the study appeared in The New England Journal of Medicine
and presented as Late-Breaking Clinical Trial at the American College of
Cardiology's 67th Annual Scientific Session and Expo in Orlando.
for this Novel Venture
high blood pressure
is one of the main
causes of premature disability and death among African-American men, who do not have as much interaction with doctors
compared to women, necessitating
this kind of community-based intervention.
‘Hypertension can be effectively controlled with the help of friends, family and peer groups based in an informal non-clinical setting’
we provide convenient and rigorous medical care to African-American men by
coming to them
in this case having pharmacists deliver that care in barbershops--blood
pressure can be controlled and lives can be saved," said Ronald G.
Victor, MD, associate director of the Smidt Heart Institute and the study's
lead author. "High blood pressure disproportionately affects the African-American
community, and we must find new ways to reach out so we can prevent strokes,
heart attacks, heart failure and early deaths."
Methods of the Study
- The study consisted of 319
African-American men enlisted from 52 barbershops in the Los Angeles
- Participants had a systolic blood
pressure measurement of more than 140 mmHg, putting them at greater risk of complications such as stroke and heart
- The men received intervention aimed
at decreasing blood pressure. Under the latest guidelines, blood pressure
below 130/80 mmHg is considered normal.
All the men were randomly assigned
to one of two groups
- In the first group,
barbers encouraged their clients to
meet specially trained pharmacists who met the men monthly in the
barbershop, prescribed blood pressure medication, checked their blood
tests and then sent progress notes to the patient's primary care physician.
- In the second group, the barbers urged their customers to
with a primary care provider for medication
and made necessary lifestyle changes, such as
more exercise and decreased salt intake.
- In patients working with both their barbers and pharmacist, systolic blood pressure (the first, or
top, number) reduced from 153 mmHg
at the start of the study to 126 mmHg after six months. This was
associated with a decrease in
diastolic blood pressure (the bottom, number) by 18 mmHg.
After six months, almost two-thirds of participants in this
group were able to bring down their blood pressure into the healthy range.
- Men who met only their barber noted their systolic blood pressure drop from 155 mmHg at the start of the
study to 145 mmHg at the end of six months. Diastolic blood pressure
readings dropped by 4 mmHg in
At the six-month mark, 11.7% men in this group were found
to have normal blood pressure.
this new study, the first of its kind shows that advice by known persons (barbers/pharmacist) to seek to advanced
medical intervention in an informal
can be effective in reducing blood pressure.
What Members of the
Study Team Have to Say
- "It's the silent killer, and it
has cost the lives and health of a lot of good men," said Eric Muhammad, whose Inglewood shop, A
New You Barbershop, participated in the study. "It's a no-brainer
that black men are at the highest risk of high blood pressure. What's
different about this study is it looks
at ways to effectively bring it down with the help of your friends, family
and support group."
Muhammad, coauthor of the study was
so passionate and committed to making a difference in the lives of other men in
his community, and he was able to enroll over 50 other
barbershops into this study and help Dr Victor in his study.
- C. Adair Blyler, DPharm, a pharmacist who participated in the study felt that location of healthcare was key to
improved outcome. He adds that the rapport and trust built with the
patients where they are is much more than in a clinical setting.
- Dr Victor says that this
level of rapport and trust is necessary to treat a chronic condition such
as hypertension, which needs ongoing lifestyle
changes as well as being compliant with medicines.
you have hypertension, it requires a lifetime commitment to taking medications
and making lifestyle changes. It is often challenging to get people who need
medication to take them, even as
costs and side effects have gone down over the years. With this program, we
have been able to overcome that barrier."
team has already begun a second phase of
to find out if the benefits can be sustained for an additional
six months. Victor also hopes to expand this study to other parts of the
country and to reach a larger population
including African-American men with more moderate hypertension.
- Ronald G. Victor, Kathleen Lynch, Ning Li, Ciantel Blyler, Eric Muhammad, Joel Handler, Jeffrey Brettler, Mohamad Rashid, Brent Hsu, Davontae Foxx-Drew, Norma Moy, Anthony E. Reid, Robert M. Elashoff. "A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops." New England Journal of Medicine, (2018); DOI: 10.1056/NEJMoa1717250