This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
This study found that the NHS Health Check is reducing cardiovascular diseases and improving prevention of other diseases through early detection and timely intervention.
Researchers compared the health records of nearly 50,000 people who had an NHS Health Check, with a similar number, matched according to their health, who did not. During follow up (of 9 years on average), those who attended the check had a lower risk of:
- dementia
- heart attack
- death.
The researchers suggest that the checks allow for one-to-one review of health behaviours, and earlier identification and treatment of underlying conditions. They say there is a need to encourage more people to attend and engage with these appointments.
More information on NHS Health Checks can be found on the NHS website.
The issue: do NHS Health Checks improve health in the long term?
The NHS Health Check programme aims to prevent conditions such as heart attack and stroke. The checks are for people in England aged 40 - 74 who do not have pre-existing conditions. They are carried out every 5 years in primary care and include blood tests and questions about health habits. People are given advice and/or treatment according to their assessed risk and NICE guidelines.
In this study, researchers assessed how effectively NHS Health Checks prevent diseases in the longer-term.
What’s new?
The researchers assessed health records of people from the UK Biobank: 48,602 people who had an NHS Health Check (or the Scottish equivalent, Keep Well) with the same number who did not. People were matched according to age, sex, other health factors (such as smoking status and alcohol intake) and deprivation. Most were women (59%) and white (96%); they were followed up for 9 years on average.
In line with previous research, diagnoses of diabetes, high blood pressure and cholesterol were higher in the group that had the check than the group that did not in the 1-2 years after the check.
Overall, compared with the group that did not, those who had a health check had lower rates of:
- atrial fibrillation (irregular, often fast heart rate; 9% lower)
- dementia (19% lower)
- heart attack (15% lower)
- acute kidney problems (23% lower)
- liver cirrhosis (44% lower)
- death (23% lower).
Why is this important?
The NHS Health Check was linked with a reduced risk of death and illness in the longer-term.
Diagnoses of high blood pressure and cholesterol were higher in the group that had the check in the first 2 years. These conditions do not have symptoms in their early stages and may have been picked up only because of the check. Similarly, the reduced risk of liver cirrhosis could be because people who attend health checks are more likely to have their liver function tested with a simple blood test.
Identifying conditions early can trigger behaviour change or medications that preserve health longer and thereby reduce the risk of more serious conditions in later years. This may explain the better health of the group that had the check. In addition, the check establishes a relationship between clinicians and patients and allows for more careful monitoring of existing and potential health issues over time.
This database study shows a link between attending NHS Health Check and an improvement in health; it does not prove that the Health Check itself caused the improvement. Findings are based on data from the UK Biobank whose participants are overall healthier and wealthier than the rest of the population. Also, most participants in the study were White British. The findings may therefore not be fully generalisable to the whole population or to people of other ethnicities.
What’s next?
Almost half (46%) of those invited for an NHS Health Check, attend. The researchers say there is a need to encourage more people to attend these appointments and for support to be provided to those who would benefit. This is particularly important for those in less wealthy areas. They hope their findings are used in public health campaigns about the importance of the checks.
In a related study, the data collected in the NHS Health Check was used to assess the risk of 10 diseases, such as dementia and heart failure, rather than the single cardiovascular risk score currently generated from the check. The researchers are planning to validate their findings in a larger, nationally-representative database.
You may be interested to read
This is a summary of: McCracken C, and others. NHS Health Check attendance is associated with reduced multiorgan disease risk: a matched cohort study in the UK Biobank. BMC Medicine 2023; 22: 1 – 13.
Articles about this study from New Scientist, The Sun, and The Mirror.
Information on staying healthy from NHS Live Well.
A paper about the inequality of support people receive after an NHS Health Check: Duddy C, and others. Understanding what happens to attendees after an NHS Health Check: a realist review. BMJ Open 2022; 12: e064237.
Funding: This study was supported by the Oxford NIHR Biomedical Research Centre and the NIHR Integrated Academic Training programme.
Conflicts of Interest: Several authors received fees and funding from pharmaceutical and biotechnology companies. Full disclosures are available on the original paper.
Disclaimer: Summaries on NIHR Evidence are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that the views expressed are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.
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