African-American males who can have their blood pressure gauged at their local barbershop have a significantly higher chance of better hypertension (high blood pressure) control, researchers reveal in Archives of Internal Medicine. High blood pressure, or hypertension is a condition in which blood pressure in the arteries is chronically high. The heart beats, forcing blood through the arteries to all parts of the body. Blood pressure is the force of blood that is pushing up against the blood vessel walls. The heart has to work harder to pump if that pressure is too high, raising the risk of organ damage, heart attack, heart failure, renal failure or aneurysm.
The authors explain, as background information:
Uncontrolled hypertension is one of the most important causes of premature disability and death among non-Hispanic black men. Compared with black women, men have less frequent physician contact for preventive care and thus substantially lower rates of hypertension detection, medical treatment and control.
Black-owned barbershops hold special appeal for community-based intervention trials because they are a cultural institution that draws a large and loyal male clientele and provides an open forum for discussion of numerous topics, including health, with influential peers.
Ronald G. Victor, M.D., who was at University of Texas Southwestern Medical Center, Dallas, and team carried out a randomized study in Dallas County, Texas involving 17 barbershops between March 2006 and December 2008; they were all owned by African-Americans.
Comparison Group – nine barbershops were randomized into the comparison group when the study began. An average of 77 patrons with hypertension per establishment (695) were given general pamphlets about hypertension.
Intervention Group – at the other eight barbershops 602 clients (75 per shop) with hypertension were given personalized, sex-specific health messaging. They could also see posters of male clients with hypertension seeking treatment. They were offered blood pressure checks when they came in for a haircut.
The researchers followed up on collected data ten months later.
The investigators report there was significantly more hypertension control in the intervention group.
- In the intervention group – the control rate for clients with hypertension rose 19.9%, from 33.8% to 53.7% at follow-up
- In the comparison group – the control rate for clients with hypertension rose 11.1%, from 40% to 51% at follow up
In other words, an 8.8% absolute difference between the two groups. The authors add that there was an 11.2% increase in hypertension treatment in the intervention group compared to 6.2% in the comparison group.
The authors concluded:
The study addresses the newly recommended policy shift away from a traditional case-management system toward novel population-based systems and community-based support for persons with hypertension. The data add to an emerging literature on the effectiveness of community health workers in the care of people with hypertension: contemporary barbers constitute a unique workforce of community health workers whose historical predecessors were barber-surgeons.
Blood pressure that is below 120/80, with 120 representing the peak pressure in the arteries (systolic measurement) and 80 the minimum pressure in the arteries (diastolic measurement) is considered normal. Pre-hypertension is when blood pressure is between 120/80 and 139/89. Hypertension is when blood pressure is 140/90 or above.
When the cause of the hypertension is unknown it is called essential hypertension, and accounts for approximately 95% of all cases. When we know the cause it is called secondary hypertension. Secondary hypertension can be directly caused by birth control pills, tumors or kidney disease.
According to the American Heart Association:
- In 2006, 51.1 per 100,000 African-American males died from hypertension, compared to 15.6 Caucasian-American males, 37.7 African-American females, and 14.3 Caucasian-American females
- 56,561 Americans died prematurely in the USA in 2006 because of hypertension
- Approximately 74.5 million Americans aged at least 20 years have hypertension
- 22.4% of Americans with hypertension are unaware of their condition
- 55.9% of Americans with hypertension do not have their condition controlled
- Hypertension is easily detected and usually controllable
- The annual number of deaths from hypertension between 1996 and 2006 rose 48.1% in the USA
- Non-Hispanic African-Americans have a significantly higher risk of developing hypertension compared to Caucasian-Americans
- African-Americans at highest risk of having hypertension are those who are overweight/obese, sedentary, with diabetes, and/or middle aged or older
Ronald G. Victor, MD; Joseph E. Ravenell, MD, MS; Anne Freeman, MSPH; David Leonard, PhD; Deepa G. Bhat, ME; Moiz Shafiq, MD; Patricia Knowles; Joy S. Storm, BS; Emily Adhikari, BA; Kirsten Bibbins-Domingo, PhD, MD, MAS; Pamela G. Coxson, PhD; Mark J. Pletcher, MD, MPH; Peter Hannan, MStat; Robert W. Haley, MD
Arch Intern Med. Published online October 25, 2010. doi:10.1001/archinternmed.2010.390
Written by Christian Nordqvist