The NHS Health Check programme in England may have prevented an estimated 4,600 to 8,400 heart attacks, strokes, or death from these causes in its first five years, according to an independent review of the programme led by Queen Mary University of London (QMUL).
The programme, which has in the past been considered 'controversial', led to an increase in diagnoses of 30 per cent for diabetes, 50 per cent for hypertension and 80 per cent for chronic kidney disease, and 40 per cent more statins were prescribed, but researchers say there is still room for improvement for treating those at higher risk.
NHS Health Check started in 2009 and is the first programme in the world to tackle prevention of heart attacks and strokes by offering a free check to every adult aged 40-74 years. The scheme offers professional advice on lifestyle changes and treatments, including statins, to reduce the risk of heart attack or stroke.
This study, published in the British Journal of General Practice, looked at the first five years of the NHS Health Check programme in three London areas (City & Hackney, Tower Hamlets and Newham) and found that:
- 85,122 attended in five years. Coverage of 85 per cent of eligible people was achieved in the most recent year, rising from 36 per cent in the first year.
- 30 per cent more new cases of diabetes, 50 per cent more new cases of hypertension and 80 per cent more new cases of chronic kidney disease were diagnosed in NHS Health Check attendees compared to non-attendees.
- 40 per cent more statins were prescribed in NHS Health Check attendees than non-attendees.
- In England, with 1.5 million attendees annually, this additional statin use could prevent an estimated 4600 to 8400 heart attacks, strokes, or death from these causes in five years as a result of attending an NHS Health Check.
- Treatment of hypertension, diabetes, and kidney disease would add further reductions in cardiovascular events.
- Attendance was higher for more deprived sections of the population and South Asians.
- The coverage of 85 per cent of eligible people found in this local study compares with around 50 per cent nationally, indicating that better coverage is achievable in England.
- Highest coverage and treatment were associated with efforts to target those at highest risk.
The introduction of this scheme was controversial, say study authors. Statins received adverse publicity and the programme's effectiveness was contested. This was largely based on a review of 16 trials of health checks, of which 12 were conducted before 1994 when neither statins nor modern antihypertensive drugs were in use.
Study lead Dr John Robson from QMUL said: "Those who attended NHS Health Checks were substantially more likely to be found with a diagnosis of a new disease, including hypertension, diabetes and chronic kidney disease. We saw a 30 to 80 per cent increase in the number of disease cases found, compared to those who did not attend, and 40 per cent more people were prescribed statins, so these are very substantial gains in public health terms.
"If you compare attendance levels with other programmes, such as the bowel screening programme, the coverage here is much better, so one would hope that would translate into earlier opportunities for greater protection for those people. However, there is still room for improvement for NHS Health Checks, especially in terms of ensuring even better treatments for those at higher risk."
The study was funded by the Department of Health, but independently conducted.
Article: NHS Health Check comorbidity and management: an observational matched study in primary care, John Robson, Isabel Dostal, Vichithranie Madurasinghe, Aziz Sheikh, Sally Hull, Kambiz Boomla, Chris Griffiths and Sandra Eldridge, British Journal of General Practice, doi: 10.3399/bjgp16X688837, published 20 December 2016.