Abstract WP240: Long Term Impact of the Los Angeles Barbershop Blood Pressure Study on Stroke/TIA and Cognitive Impairment

Abstract

Background: Individuals with poorly controlled blood pressure (BP) have a heightened risk of stroke and vascular cognitive impairment. BP reduction has been associated with reduced risk of future stroke and cognitive impairment. Black Americans are disproportionately affected by hypertension and neurologic-target organ damage. Interventions targeted to reduce these disparities are greatly needed. From 2/2015 - 7/2017, 307 Black men were enrolled into a cluster randomised, pharmacist-led BP reduction intervention at 52 Black-owned barbershops in Los Angeles, CA [the Los Angeles Barbershop BP Study (LABBPS)] which demonstrated significant improvement in BP control sustained over a 12-month period. The current study evaluates the long-term impact of the intervention on incident stroke/TIA and prevalent mild cognitive impairment (MCI). Methods: Living participants from the LABBPS were contacted via telephone for interval health history inquiring about the development of symptoms consistent with stroke/TIA since trial end and via telephone interview for Cognitive Status (TICS-M); whereby a score ≤34 was considered positive for possible amnestic MCI. Rates of stroke/TIA were compared using a Pearson’s Chi-squared test. Results: Out of 288 participants, 115 men (50%) with mean (SD) age 62 (9) years, were successfully contacted a median of 6 years after trial end. The distribution of TICS-M scores was similar between groups with 71% and 70% having an abnormal result in the intervention and control groups respectively. Self-reported stroke/TIA occurred in 4 men in the intervention group and 9 in the control group (p = 0.13). Conclusion: Barbershop-based interventions have proven effective in lowering BP in Black men, a group at disparate risk for neurovascular complications. The preliminary results of our follow-up study do not show a significant difference in possible MCI between treatment arms, though there was a trend towards lower incident stroke/TIA seen in the intervention group. Limitations include a lack of interval BP values, unknown durability of the intervention beyond 12 months, and disproportionate impact of COVID-19 pandemic on the health of African American communities which is not accounted for in this analysis.