A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops
- 4 April 2018
- journal article
- research article
- Published by Massachusetts Medical Society in The New England Journal of Medicine
- Vol. 378 (14), 1291-1301
- https://doi.org/10.1056/NEJMoa1717250
Abstract
BACKGROUND Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings. METHODS We enrolled a cohort of 319 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops (nontraditional health care setting) in a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention (in which barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy under a collaborative practice agreement with the participants' doctors) or to an active control approach (in which barbers encouraged lifestyle modification and doctor appointments). The primary outcome was reduction in systolic blood pressure at 6 months. RESULTS At baseline, the mean systolic blood pressure was 152.8 mm Hg in the intervention group and 154.6 mm Hg in the control group. At 6 months, the mean systolic blood pressure fell 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 (95% confidence interval, 14.7 to 28.4; P<0.001). A blood-pressure level of less than 130/80 mm Hg was achieved among 63.6% of the participants in the intervention group versus 11.7% of the participants in the control group (P<0.001). In the intervention group, the rate of cohort retention was 95%, and there were few adverse events (three cases of acute kidney injury). CONCLUSIONS Among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management in barbershops by specialty-trained pharmacists.Funding Information
- National Heart, Lung, and Blood Institute (R01HL117983)
This publication has 40 references indexed in Scilit:
- Differential Treatment of Hypertension by Primary Care Providers and Hypertension Specialists in a Barber-Based Intervention Trial to Control Hypertension in Black MenThe American Journal of Cardiology, 2013
- Improved Blood Pressure Control Associated With a Large-Scale Hypertension ProgramJAMA, 2013
- 2013 ESH/ESC Guidelines for the management of arterial hypertensionJournal of Hypertension, 2013
- KDIGO Clinical Practice Guidelines for Acute Kidney InjuryNephron Clinical Practice, 2012
- CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trialsInternational Journal of Surgery, 2011
- Effectiveness of a Barber-Based Intervention for Improving Hypertension Control in Black MenJAMA Internal Medicine, 2011
- Factors Associated With Hypertension Awareness, Treatment, and Control in Dallas County, TexasArchives of Internal Medicine, 2008
- Barbershops as Hypertension Detection, Referral, and Follow-Up Centers for Black MenHypertension, 2007
- Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureHypertension, 2003
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureThe JNC 7 ReportJAMA, 2003