March 14, 2011

Barbers Help Black Men Beat High Blood Pressure

Photo of an African American man at the barber

A new study found that barbers successfully helped fight high blood pressure in African-American men. The results support an increasingly popular practice, in which trusted members of the community deliver important health messages to those who need them.

About 72 million people nationwide have high blood pressure, or hypertension. That’s about 1 in 3 adults. The condition itself causes no symptoms, but left untreated it can damage the heart, blood vessels, kidneys and other parts of the body. African Americans are at particularly high risk of developing high blood pressure. Genes seem to play some role, but so do diet and other lifestyle factors.

One known problem among African-American men is the low rate of preventive care. As a result, their hypertension is poorly controlled, which leads to premature deaths and disability due to strokes, heart attacks, heart failure and kidney failure. Because of this, developing effective medical outreach programs with community partners is a major public health priority. African-American churches often serve as partners, but regular church attendance is less common among African-American men than women. Outreach programs through African-American-owned barbershops are becoming increasingly common, but whether they're truly an effective approach hasn't been shown.

A research team led by Dr. Ronald G. Victor, now at the Cedars-Sinai Heart Institute in Los Angeles, and Dr. Robert Haley of the University of Texas Southwestern Medical Center set out to evaluate the effects of barbershop-based outreach on blood pressure control. They screened African-American male patrons for high blood pressure at 17 African-American-owned barbershops in Dallas County, Texas, and enlisted about 1,300 men with hypertension to participate. The study was funded by NIH's National Heart, Lung and Blood Institute (NHLBI) and others.

In 9 of the shops, barbers continually offered blood pressure checks with haircuts and encouraged their patrons to follow up with physicians. Participants in the remaining 8 comparison shops received standard blood pressure pamphlets. After 10 months, the researchers collected follow-up data. Their primary measurement was hypertension control rate — the percent of patrons whose blood pressure was controlled to recommended levels.

As reported in the February 28, 2011, edition of Archives of Internal Medicine, hypertension control in both groups improved significantly, but more so in the intervention group. In the comparison group, the control rate rose by 11% (from 40% to 51%). In the intervention group, the control rate improved by 20% (from 34% to 54%).

Because the comparison group wasn’t truly an inactive control group, the greater improvement in the intervention group is particularly noteworthy. The true magnitude of the intervention's effect, however, will require further study. Nevertheless, this study shows that a trusted person in the community can play an important role in health promotion.

"The barbers were the heroes of this story. They really stepped forward and made it part of their barber practice," Haley says. "They helped us show that social settings can be an integral part of health care in the black male population."

— by Harrison Wein, Ph.D.

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