Be Well

Storytellers help neighbors lower blood pressure

January 24, 2011

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Peer-to-peer storytelling may help African-Americans deal with high blood pressure, according to a new study. Dr. Thomas K. Houston of the University of Massachusetts Medical School and the VA Medical Center in Bedford studied a group of 299 African Americans with hypertension in Birmingham, Ala., for nine months. Half were randomly chosen to receive DVDs of fellow patients talking about their experiences with high blood pressure and offering advice on how to take medication and talk with doctors. Among the DVD group, those with uncontrolled hypertension experienced a larger drop — 12 points more, on average in systolic blood pressure (the top number) than the comparison group, which did not get DVDs. The DVD group’s systolic pressure dropped from 152 to 137.

Storytelling has been studied as a means of educating at-risk patients on medical issues such as smoking and breast cancer screening, but according to Houston this was the first such study with hypertension patients. Storytellers were chosen from community focus groups for their eloquence and persuasiveness, and the DVDs included supplementary information to go along with the stories. Houston plans to study patients in other cities, hoping to determine whether people only respond to local storytellers.

BOTTOM LINE: Storytelling may be an effective tool for doctors to treat African Americans with high blood pressure.

CAUTIONS: The DVDs made no difference in patients whose hypertension was controlled with medication. The findings may not be applicable to other racial groups.

WHERE TO FIND IT: Annals of Internal Medicine, January 2011.

Antidepressant may reduce hot flashes Menopausal women experienced some relief from hot flashes when given an FDA-approved antidepressant in a recent study. Ellen W. Freeman of the University of Pennsylvania led the research, which compared 104 women who were randomly selected to get the drug escitalopram (Lexapro) with 101 who received a placebo. After eight weeks, the group on the antidepressant reported a mean drop in hot flashes from 9.9 to 5.3 per day, which was about one less hot flash per day than the placebo group. The treatment group also reported somewhat less severe hot flashes. Freeman said that in general, African-American women report more frequent and severe hot flashes, but that in this trial they experienced the same level of relief from the drug as other participants.

A few women dropped out of the trial early because of reported side effects, which typically include insomnia and nausea. The government-funded trial is part of an ongoing series of studies to find alternatives to hormone replacement therapy for menopausal women.

BOTTOM LINE: Escitalopram, a known antidepressant, may be effective for treating menopausal hot flashes.

CAUTIONS: This is the first major study of the drug for this use, and it involved only about 200 women. Freeman has received research funding and consulting and speaking fees from the maker of Lexapro.

WHERE TO FIND IT: Journal of the American Medical Association, Jan. 19.