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Barbers recruited to cut blood pressure

Posted - Nov. 8, 2004 at 8:20 a.m.



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NEW ORLEANS, Nov 08, 2004 (United Press International via COMTEX) -- The neighborhood barbershop might be a good place to cut high blood pressure as well as hair, and while walking uphill improves cardiovascular function, walking downhill helps other health indicators, heart researchers reported at their annual conference.

Studies presented at the American Heart Association meeting in New Orleans, which began Sunday, demonstrate healthy consequences can pop up almost anywhere.

Researchers recruited barbers in minority communities such as Dallas in an attempt to reach African-American patrons who might not have their blood pressure under control.

High blood pressure can lead to stroke and heart disease -- and hypertension control is very poor among African-Americans and other minorities, said Paul Hess, a researcher at the University of Texas Southwestern Medical School at Dallas.

"We saw significant decreases in blood pressure in this experiment," Hess said. "African-American men constitute a group with the greater burden of premature cardiovascular disability and death from uncontrolled hypertension -- high blood pressure."

Attempts to reach this population for testing and treatment have not been overwhelmingly successful.

"We tested the effectiveness in barbershops," Hess told United Press International, "which represent, for many African-American men, the social epicenter of daily urban life. The barbershop is an efficient screening site because of a high client volume -- 150-550 customers per shop in a week, a high screening rate and a high prevalence rate of elevated blood pressure."

Hess said about 28 percent of men had blood pressure elevated above the standard of 140/90 millimeters of mercury.

"Through this intervention we were able to achieve a 5 mm/Hg drop in systolic blood pressure (the top figure) and a 2 mm/Hg drop in diastolic blood pressure (the bottom figure)," Hess said. "For a population study, those are excellent figures."

"Those are excellent results," agreed Thomas Allison, a consultant in internal medicine and cardiovascular disease at the Mayo Clinic, Rochester, Minn.

Allison said the follow-up plan, in which individuals with high blood pressure readings were referred to doctors, was especially well-conceived. He noted other programs, in malls and shopping centers, that did not have regular follow-up procedures tended not be have a long-term effect.

In Hess' project, 8,742 visits were made to three barbershops and 7,483 times customers were approached to receive blood pressure testing; 7,101 times they consented.

In a pilot program, clinicians operated the blood pressure monitors in the barbershops, but after an initial period, the operation was turned over to the barbers.

"Trained field staff was present during peak business hours to encourage medical referral for untreated or inadequately treated hypertension during the initial program," Hess said. "To encourage this behavior, we provided blood pressure feedback in the form of wallet-size report cards to reinforce systolic and diastolic blood pressure goals; haircut discounts for blood pressure measurement and for achieving goal blood pressure, and peer experience stories from other men in the shop who made behavior changes leading to improved blood pressure."

Also at the conference -- researchers reported that what goes up must come down -- especially when going up is for exercise. They studied out-of-shape volunteers who spent two months hiking up or down the Alps.

Dr. Heinz Drexel of the Vorarlberg Institute for Vascular Investigation and Treatment at the Academic Teaching Hospital in Feldirch, Austria, said hiking up hill reduces low density lipoprotein -- the bad cholesterol.

"And this was expected, he said, "but what was unexpected was that hiking down mountains also lowered LDL."

Hiking uphill also lowers triglycerides, but downhill hikes also significantly improve glucose tolerance, which suggests that "downhill exercise may be a good option for people with diabetes," he said at a news conference.

In this study, 45 healthy but sedentary volunteers agreed to exercise three to five times a week for four months. For two months the volunteers hiked up mountains and road down on cable cars, and for two months they road up on the cable cars and hiked down the mountain.

"The mountains were about a 30 degree incline," said Drexel, who told UPI a good alternative for people who don't live in mountainous regions would be "walking up or down several flights of stairs."

Dr. Ray Gibbons, a professor of medicine at the Mayo Clinic in Rochester, said he was intrigued by the finding and noted: "I regularly walk up the stairs to my office and then take the elevator down. This study suggests that I should change that practice."

--

Ed Susman covers medical research for UPI Science News. E-mail sciencemail@upi.com

Copyright 2004 by United Press International.

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