Key result
NHS Health Check attendance linked to a ~166% higher rate of new hypertension diagnoses.
Why the study?
With the NHS Health Check cardiovascular prevention programme reaching 10 years of implementation, this study evaluated attendance, new diagnoses, and treatment in relation to equity indicators.
Does attendance at an NHS Health Check improve new diagnoses and treatment rates in eligible people aged 40-74 years?
Observational (n=3,492,816)
Yes
Does attendance at an NHS Health Check improve new diagnoses and treatment rates in eligible people aged 40-74 years?
Hazard Ratio: 2.66 (95% CI 2.51–2.81)
Absolute Event Rate: 2.5% vs 0.9%
p-value: p=<0.001
NHS Health Checks increase the detection and treatment of cardiovascular risk factors, but overall uptake and treatment of high-risk individuals remain low.
Attendance at NHS Health Checks was associated with higher diagnosis and treatment rates; leaves open whether broader uptake improves outcomes.
BACKGROUND: The NHS Health Check cardiovascular prevention programme is now 10 years old. AIM: To describe NHS Heath Check attendance, new diagnoses, and treatment in relation to equity indicators. DESIGN AND SETTING: A nationally representative database derived from 1500 general practices from 2009-2017. METHOD: The authors compared NHS Health Check attendance and new diagnoses and treatments by age, sex, ethnic group, and deprivation. RESULTS: In 2013-2017, 590 218 (16.9%) eligible people aged 40-74 years attended an NHS Health Check and 2 902 598 (83.1%) did not attend. South Asian ethnic groups were most likely to attend compared to others, and females more than males. New diagnoses were more likely in attendees than non-attendees: hypertension 25/1000 in attendees versus 9/1000 in non-attendees; type 2 diabetes 8/1000 versus 3/1000; and chronic kidney disease (CKD) 7/1000 versus 4/1000. In people aged ≥65 years, atrial fibrillation was newly diagnosed in 5/1000 attendees and 3/1000 non-attendees, and for dementia 2/1000 versus 1/1000, respectively. Type 2 diabetes, hypertension, and CKD were more likely in more deprived groups, and in South Asian, Black African, and Black Caribbean ethnic groups. Attendees were more likely to be prescribed statins (26/1000) than non-attendees (8/1000), and antihypertensive medicines (25/1000 versus 13/1000 non-attendees). However, of the 117 963 people with ≥10% CVD risk who were eligible for statins, only 9785 (8.3%) were prescribed them. CONCLUSION: Uptake of NHS Health Checks remains low. Attendees were more likely than non-attendees to be diagnosed with type 2 diabetes, hypertension, and CKD, and to receive treatment with statins and antihypertensives. Most attendees received neither treatment nor referral. Of those eligible for statins, <10% were treated. Policy reviews should consider a targeted approach prioritising those at highest CVD risk for face-to-face contact and consider other options for those at lower CVD risk.
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Robson et al. (2021) conducted an observational in Cardiovascular disease risk (n=3,492,816). NHS Health Check attendance vs. Non-attendance was evaluated on New diagnosis of hypertension within 12 months (HR 2.66, 95% CI 2.51 to 2.81, p=<0.001). NHS Health Check attendees were significantly more likely to be newly diagnosed with hypertension (HR 2.66) and other cardiovascular risk factors compared to non-attendees, despite overall low programme uptake.
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