Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): Results after one year

Abstract

ObjectiveWe aimed to assess whether the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program, was associated with reduction in CVD risk in attendees after one year. MethodsWe extracted data from patients aged 40–74years, with high estimated CVD risk, who were registered with general practices in a deprived, culturally diverse setting in England. We included 4748 patients at baseline (July 2008–November 2009), with 3712 at follow-up (December 2009–March 2011). We used a pre–post study design to assess changes in global CVD risk, individual CVD risk factors and statin prescription in patients with a complete and partial Health Check. ResultsThere were significant reductions in mean CVD risk score (28.2%; 95% confidence interval (CI)=27.3–29.1 to 26.2%; 95% CI, 25.4–27.1), diastolic blood pressure, total cholesterol levels and lipid ratios after one year in patients with a complete Health Check. Statin prescription increased from 14.0% (95% CI=11.9–16.0) to 60.6% (95% CI=57.7–63.5). ConclusionsThe introduction of NHS Health Check was associated with significant but modest reductions in CVD risk among screened high-risk individuals. Further cost-effectiveness analysis and work accounting for uptake is required to assess whether the program can make significant changes to population health.