What Happened When Barbers Helped Black Men With High Blood Pressure

High blood pressure that goes untreated can boost a person’s risk of stroke, heart attack or congestive heart failure. But not everyone can or will take the time to monitor and manage their blood pressure with regular doctor’s appointments.

Researchers from Cedars–Sinai Medical Center wanted to explore a way to make blood pressure care more accessible to communities that most need it. They had the creative idea to enlist the help of barbers with access to high-risk populations. The results surprised everyone.

Blood pressure screenings at barbershops

“High blood pressure is a leading cause of death and disability among African-American men,” says Benico Barzilai, MD, Head of Clinical Cardiology at Cleveland Clinic. Dr. Barzilai did not participate in the study.

Diets high in salt play a part, Dr. Barzilai says. And high blood pressure often runs in African-American families, he says.

The study’s authors theorized that one good way to reach African-American men is to meet them where they gather — in the barbershops of their community. The study found that barbers were able to successfully help many men reduce their high blood pressure.

“The results were striking,” Dr. Barzilai says.

The six-month study included 319 African-American men who participated from 52 barbershops throughout Los Angeles, Calif. The men were split into two groups:

• Group 1: Barbers encouraged their customers to talk and meet with a pharmacist monthly in the barbershop.
• Group 2: Barbers recommended lifestyle changes and encouraged the men to see their primary care physicians for follow-up treatment.

Many men routinely go to the same barbershop — it can be both a cultural and a social event, Dr. Barzilai says.

“The researchers of this particular study examined other studies that did screenings in barbershops. Those studies were also effective in finding high blood pressure among African-American men,” he says.

Study results ‘unparalleled’

The main difference in this study is that a pharmacist on-site prescribed blood pressure medication (under physician orders) and monitored blood tests. (The pharmacist sent progress notes to each customer’s primary care provider.)

After six months of working with barbers and a pharmacist on-site:

• Nearly two-thirds reduced their blood pressure to a healthy range
• Systolic blood pressure dropped more than 20 points on average
• Diastolic blood pressure dropped by about 18 points

Those significant drops surprised Dr. Barzilai. “Most blood pressure studies have a 10- to 15-point drop,” he says. “The men in the group who worked closely with the pharmacists saw an over 20-point drop in blood pressure. That got my attention. That is unparalleled in most blood pressure trials.”

The men in the group with just the barber saw their systolic blood pressure drop about 10 points, while their diastolic blood pressure dropped by about 4 points. In this group, 11.7 percent of the participants brought their blood pressure into the healthy range.

A changing approach to treatment

Dr. Barzilai hopes the healthcare community can build on the momentum of this study and replicate its success in other cities. For him, one big takeaway is that physicians may need to alter the way they treat patients.

“Traditionally, we would screen these patients in a barbershop, but then we would tell them to make an appointment with their primary care doctor,” he says.

“What this study did, which was novel, is bring the treatment to the patient,” he says. “The pharmacists were able to prescribe the medicine under the guidance of the doctor on the spot. This tells us that we need to rethink how we do medical care in the future.”

He also says black men who start thinking about their health at an earlier age will benefit. “If you can reduce your blood pressure, you will see a sustained reduction in risk of stroke and heart attacks,” he says.