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NHS Health Check attendance is associated with reduced multiorgan disease risk: a matched cohort study in the UK
Celeste McCracken1, Zahra Raisi-Estabragh2,3, Liliana Szabo2,3,4
1Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK. celeste.mccracken@cardiov.ox.ac.uk.
Insights
The UK National Health Service (NHS) Health Check program reduces long-term disease risk and mortality. While initial diagnoses may increase, long-term outcomes show significant benefits for cardiovascular and overall health.
Area of Science:
- Public Health
- Preventive Medicine
- Epidemiology
Background:
- The National Health Service (NHS) Health Check is a UK-wide preventive program aimed at screening for cardiovascular disease risk.
- Its long-term effectiveness in disease prevention requires further investigation.
Purpose of the Study:
- To evaluate the long-term effectiveness of the NHS Health Check in preventing new disease diagnoses.
- To compare disease incidence and mortality rates between NHS Health Check recipients and matched non-recipients.
Main Methods:
- Utilized UK Biobank data, matching 48,602 NHS Health Check recipients with 48,602 non-recipients based on extensive covariates.
- Ascertained diagnoses over an average of 9 years for conditions including hypertension, diabetes, stroke, cardiovascular mortality, and all-cause mortality.
- Employed time-varying survival modeling to compare adjusted outcome rates between the groups.
Main Results:
- Higher initial diagnosis rates for hypertension, high cholesterol, and chronic kidney disease were observed in the 2 years post-check.
- Longer-term follow-up revealed significantly lower risks for multiorgan diseases and reduced cardiovascular and all-cause mortality among NHS Health Check recipients.
- These findings suggest a beneficial impact on longer-term health outcomes.
Conclusions:
- The NHS Health Check is associated with reduced incidence of disease across multiple organ systems.
- This benefit may stem from risk modification via earlier detection and treatment of key risk factors.
- The study supports the effectiveness of preventive interventions in mitigating longer-term multimorbidity.
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.
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