Abstract
Abstract
Background
The NHS Health Check is a preventive programme in the UK designed to screen for cardiovascular risk and to aid in primary disease prevention. Despite its widespread implementation, the effectiveness of the NHS Health Check for longer-term disease prevention is unclear. In this study, we measured the rate of new diagnoses in UK Biobank participants who underwent the NHS Health Check compared with those who did not.
Methods
Within the UK Biobank prospective study, 48,602 NHS Health Check recipients were identified from linked primary care records. These participants were then covariate-matched on an extensive range of socio-demographic, lifestyle, and medical factors with 48,602 participants without record of the check. Follow-up diagnoses were ascertained from health records over an average of 9 years (SD 2 years) including hypertension, diabetes, hypercholesterolaemia, stroke, dementia, myocardial infarction, atrial fibrillation, heart failure, fatty liver disease, alcoholic liver disease, liver cirrhosis, liver failure, acute kidney injury, chronic kidney disease (stage 3 +), cardiovascular mortality, and all-cause mortality. Time-varying survival modelling was used to compare adjusted outcome rates between the groups.
Results
In the immediate 2 years after the NHS Health Check, higher diagnosis rates were observed for hypertension, high cholesterol, and chronic kidney disease among health check recipients compared to their matched counterparts. However, in the longer term, NHS Health Check recipients had significantly lower risk across all multiorgan disease outcomes and reduced rates of cardiovascular and all-cause mortality.
Conclusions
The NHS Health Check is linked to reduced incidence of disease across multiple organ systems, which may be attributed to risk modification through earlier detection and treatment of key risk factors such as hypertension and high cholesterol. This work adds important evidence to the growing body of research supporting the effectiveness of preventative interventions in reducing longer-term multimorbidity.
Funder
NIHR Oxford Biomedical Research Centre
Publisher
Springer Science and Business Media LLC
Reference45 articles.
1. Marthias T, Anindya K, Ng N, McPake B, Atun R, Arfyanto H, et al. Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study. BMJ Open. 2021;11(2):e041870.
2. Head A, Fleming K, Kypridemos C, Pearson-Stuttard J, O’Flaherty M. Multimorbidity: the case for prevention. J Epidemiol Commun Health. 2021;75(3):242–4.
3. NHS. The NHS Long Term Plan. 2019. https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf. Accessed 02 Nov 2023.
4. Matthews J. We need a shift from reactive to proactive care. BMJ. 2012;344:e1225.
5. Hylton K, Thompson K, Kearney M, Lagord C. NHS Health Check Best practice guidance: for commissioners and providers (Public Health England). 2019. https://www.healthcheck.nhs.uk/commissioners-and-providers/national-guidance/. Accessed 02 Nov 2023.