NHS 'health checks' reduce cardiovascular disease risk, new study finds

Attending a health check as part of the England National Health Services "Health Check" programme is associated with increased risk management interventions and decreased risk factors for cardiovascular disease in the six years following the check, according to a new study published this week in PLOS Medicine by Samah Alageel of King Saud University, Saudi Arabia, and colleagues from King's College London, UK.

In 2009, the NHS introduced the Health Check programme, designed to provide checkups to adults in England aged 40-74 and spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia. One review, however, found that the programme did not decrease morbidity or mortality among participants. In the new study, researchers studied data from 127,891 participants who completed the health check between 2010 and 2016, as well as data from 322,910 matched controls over six years' follow-up.

The authors found that health check participants had slightly lower baseline body mass index (BMI), blood pressure (SBP) and fewer were smokers (21% in health check participants vs. 27% in controls). Health check participants were five times more likely to receive weight management advice, three times more likely to receive smoking cessation advice, and their use of statins was 24% higher.

Six years after taking part in health checks, people who had a health check had net reductions in body mass index, systolic blood pressure, and smoking status. The authors acknowledge that lack of randomization as well as missing data in electronic medical records could have introduced bias into the results.

"These results show that the NHS Health Check programme carries a potential for reducing cardiovascular risk through the early assessment and management of risk factors. However, the programme could benefit from and should be supported with population-wide interventions to improve its outcomes" comments lead author Samah Alageel.

"People who take up a health check may be healthier than controls but are more likely to receive risk factor interventions. Reductions in risk up to six years following a health check may be of public health importance but we need to be sure these benefits are shared by those most at risk" notes Professor Martin Gulliford, School of Population Health and Environmental Sciences, King's College London.

"While net changes in risk factor values were generally of small magnitude these were sustained for up to six years following the health check and the cumulative impact of these changes could be of public health importance across the population at risk," the authors say.

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Research Article

Funding:

This study was funded by the National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London. This research project was supported by a grant from the "Research Center of the Female Scientific and Medical Colleges", Deanship of Scientific Research, King Saud University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

The authors have declared that no competing interests exist.

Citation:

Alageel S, Gulliford MC (2019) Health checks and cardiovascular risk factor values over six years' follow-up: Matched cohort study using electronic health records in England. PLoS Med 16(7): e1002863. https://doi.org/10.1371/journal.pmed.1002863

Image Credit: rawpixel, Pixabay

Author Affiliations:

Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
School of Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom

In your coverage please use this URL to provide access to the freely available paper: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002863

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