A unique study that combined barbershop-based health outreach with the delivery of care onsite by a specialty-trained pharmacist resulted in significantly lower blood pressure in African-American men after just six months. The study was presented by Ronald G. Victor, MD, FACC, on Monday, March 12 in a Late-Breaking Clinical Trial session at ACC.18 in Orlando, FL. The work was published simultaneously in The New England Journal of Medicine.

Researchers recruited 319 African-American men ages 35 to 71 years whose baseline systolic blood pressure was higher than 140 mm Hg from 52 Los Angeles County barbershops. Of the 309 men who completed the study, 132 were randomly assigned to receive monitoring and medication management from a pharmacist (intervention group) and 171 to receive encouragement from their barber on lifestyle recommendations and making doctor appointments (control group). Pharmacists measured blood pressure and monitored plasma electrolyte levels for men in the intervention group. The primary outcome was reduction in systolic blood pressure at six months; the secondary outcome was reduction in diastolic blood pressure.

After six months, 64 percent of men in the intervention group had blood pressure in the normal range, compared with just 12 percent of the control group. In the intervention group, systolic blood pressure decreased from 153 mm Hg at baseline to 126 mm Hg, and diastolic blood pressure decreased by 18 mm Hg. In contrast, in the control group, systolic blood pressure decreased from 155 mm Hg to 145 mm Hg, and diastolic blood pressure dropped by 4 mm Hg.

At baseline, about one-half of participants in both groups were taking at least one blood pressure medication. After six months, 100 percent of those in the intervention group and 63 percent of those in the control group were taking blood pressure medications.

Researchers are now studying whether the effects are sustained for an additional six months. They hope to expand the program to other parts of the country. "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," Victor said. "If this model was scaled up and sustained, millions of lives could be saved, and many heart attacks and strokes could be prevented."

Keywords: ACC18, ACC Annual Scientific Session, Primary Prevention, Blood Pressure, Pharmacists, Medication Therapy Management, National Heart, Lung, and Blood Institute (U.S.), Patient Satisfaction, Confidence Intervals, Goals, Hypertension, Blood Pressure Determination, Systole, Barbering, Drug Therapy, Combination, Health Promotion

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