Storytelling to Improve Blood Pressure

Benefits of a culturally appropriate storytelling intervention were similar to those of antihypertensive drugs.

Can patient-to-patient storytelling, i.e., narrative communication, help to lower blood pressure? In this study of hypertensive black patients in Alabama, researchers identified patients in focus groups who clearly and persuasively described their experiences with hypertension; selected patients served as storytellers on DVDs and offered lessons about how to interact with physicians and how to achieve better medication adherence, diet, and exercise. The 231 study participants randomly received either the storytellers’ DVDs or DVDs about general health issues unrelated to hypertension. Intervention patients spent an average of 88 minutes watching the storytellers’ DVDs.

Patients in both groups who had controlled hypertension at baseline exhibited no significant changes in blood pressure 6 to 9 months later. However, intervention patients with uncontrolled hypertension at baseline exhibited significant reductions in mean blood pressure — 15 mm Hg systolic (vs. 3 mm Hg in controls) and 3 mm Hg diastolic (vs. no change in controls).

Comment: In this randomized trial, storytelling by black patients for black patients achieved dramatic reductions in blood pressure — 15 mm Hg systolic and 3 mm Hg diastolic relative to controls. With this approach, the authors note, “listeners may be influenced if they actively engage in a story, identify themselves with the storyteller, and picture themselves taking part in the action.” The magnitude of the effect is similar to that of antihypertensive medications. If the study can be replicated and if the benefits are sustained over time, the intervention would be a substantial achievement — one that would also force us to reevaluate how we deliver messages to our increasingly diverse patient populations.

Jamaluddin Moloo, MD, MPH

Published in Journal Watch General Medicine February 10, 2011

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