Have Faith: Community-Based Interventions Can Reduce Blood Pressure in African-Americans

Photo of Ivor BenjaminIvor J. Benjamin, M.D., FAHA, FACC, President, American Heart Association, 2017-18; Professor of Medicine and Director of the Cardiovascular Center at Froedtert Hospital and the Medical College of Wisconsin

Knowing the burden of cardiovascular disease and its risk factors on African-Americans, I was eager to read the results of the Faith-based Approaches in the Treatment of Hypertension (FAITH) Trial.

Published today in Circulation: Cardiovascular Quality and Outcomes, it’s the largest community-based study to evaluate the effectiveness of a comprehensive lifestyle intervention in churches to reduce blood pressure among African-Americans.

In the cluster randomized controlled trial, New York City churchgoers with uncontrolled high blood pressure who participated in a faith-based lifestyle change curriculum combined with motivational interviewing had significant reductions in systolic blood pressure over six months, compared to those who received health education alone in sessions led by experts.

Fellow churchgoers were trained to deliver the faith-based curriculum, which included prayer, scripture and faith-based discussion related to health.

Participants were encouraged to speak with their physicians about their medications and any problems they experienced, so the study couldn’t determine how much of the difference in blood pressure resulted from lifestyle improvements versus changes in medication or better medication adherence.

Nonetheless, the study confirms the value of community-based interventions delivered by trusted community members. It adds to previous evidence that showed lay health educators are dependable partners in implementing community-based hypertension control programs.

These approaches can play a critical role in African-American communities, where lack of health insurance or distrust of the healthcare system may limit access to care. They bring care out of the hospital system and into more accessible and trustworthy settings for many recipients.

Future efforts should focus on how to maximize the potential public health impact of community-based interventions, such as increasing participant enrollment, engagement and retention. Then, we’ll need to scale up and sustain what works.

Meanwhile, other community-based efforts can help transform environments to make healthier choices more accessible, affordable and attractive for everyone — like maintaining safe spaces for physical activity and providing healthier food options in corner stores, worksites and other public places.

Both approaches will be necessary to reduce the burden of CVD and stroke in all communities and promote equity in African-Americans’ cardiovascular health. I have faith that it’s within reach.