Abstract
BackgroundTo evaluate the effect of NHS Health Checks on cardiovascular risk factor detection and inequalities.MethodsMatched cohort study in the Clinical Practice Research Datalink, including participants who received a health check in England between 1 April 2010 and 31 March 2013, together with matched control participants, with linked deprivation scores.ResultsThere were 91 618 eligible participants who received a health check, of whom 75 123 (82%) were matched with 182 245 controls. After the health check, 90% of men and 92% of women had complete data for blood pressure, total cholesterol, smoking and body mass index; a net 51% increase (P < 0.001) over controls. After the check, gender and deprivation inequalities in recording of all risk factors were lower than for controls. Net increase in risk factor detection was greater for hypercholesterolaemia (men +33%; women +32%) than for obesity (men +8%; women +4%) and hypertension in men only (+5%) (all P < 0.001). Detection of smoking was 5% lower in health check participants than controls (P < 0.001). Over 4 years, statins were prescribed to 11% of health -check participants and 7.6% controls (hazard ratio 1.58, 95% confidence interval 1.53–1.63, P < 0.001).ConclusionNHS Health Checks are associated with increased detection of hypercholesterolaemia, and to a lesser extent obesity and hypertension, but smokers may be under-represented.
Highlights
Cardiovascular diseases remain a major public health concern in the UK,[1] as well as accounting for substantial healthcare costs.[2]
In a study utilizing primary care electronic health records from the Clinical Practice Research Datalink (CPRD), we evaluated the yield of NHS Health Checks[12] and found that for every 1000 men assessed, there were 205 smokers identified, 355 with hypertension and 633 with elevated cholesterol
As well as examining aggregate effects, we aimed to evaluate the impact of the health check programme at different levels of deprivation, and in men and women, in order to begin to understand the effect of the programme on health inequalities
Summary
Cardiovascular diseases remain a major public health concern in the UK,[1] as well as accounting for substantial healthcare costs.[2] Since 2010, NHS Health Checks, a new programme for prevention of heart disease, stroke, kidney disease and diabetes has been introduced in England.[3] The NHS Health Check programme aims to provide 5 yearly cardiovascular risk assessment for adults aged 40–74 years who have not yet developed cardiovascular disease and are not being treated for elevated cardiovascular risk. The programme has attracted controversy[4,5,6] because older randomized trials suggest that health checks may increase healthcare utilization without yielding health benefits,[7] while the results of more recent trials of cardiovascular risk reduction[8] question whether universal cardiovascular risk assessment in primary care could prove cost-effective. NHS Health Checks on cardiovascular risk factor detection and inequalities
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
