The social challenge of controlling blood pressure

Controlling blood pressure is not only a medical challenge, but a social one as well.

In the African-American community, the instance of hypertension is particularly high. The condition, in general, is difficult to control because it relies heavily on changing eating and exercise habits.

A recent study used video tapes of people with hypertension candidly talking about how they manage their blood pressure. The videos were viewed by other patients and, after three months,  that group’s blood pressure was more in control.

The study, “Stories to Improve Blood Pressure: Findings from a Culturally Sensitive Randomized Trial” (pdf link),  appears in the Jan. 18 issue of Annals of Internal Medicine.

Tom Houston of the University of Massachusetts Medical School authored the study. He said listening to a story and relating to the person in the story is likely to enhance  attention to the message.

“When we’re presented with facts our brains often tend to say ‘Is that related to me or not?’ And then to begin to provide rationales on why it may not be related to,” he said. “Health messages through storytelling, the relatedness of the story teller and the person watching the story, suppresses that ‘Well it’s not me’ ”

Houston said communication, especially from people with similar backgrounds, can bring more change than a doctor’s orders. He said the videos created a personal relationship which made the viewers more susceptible to behaviorial change.

Alfred Bove with Temple University School of Medicine  said peer-to-peer education is underutilized especially in illnesses that are easy to ignore. “If you look at high blood pressure or if you look at, let’s say high cholesterol where people are at risk. There’s no evidence that’s going on,” he said. “Most people don’t get stimulated by their medical disorder in the same way a person who has a fairly overt disorder.”

Bove said it’s most common to see this type of support in weight-loss programs or from people with illnesses such as heart failure.