NHS Health Check attendance is associated with reduced multiorgan disease risk: a matched cohort study in the UK Biobank.

Adriana Roca-Fernández, Anya Topiwala, John Robson, Celeste McCracken, Zahra Raisi-Estabragh, Betty Raman, Masud Husain, Thomas E Nichols, Steffen E Petersen, Stefan Neubauer, Liliana Szabo

Journal: BMC medicine 2024;22(1):1

PMID: 38254067

Free Full Text on BioMed Central View on PubMed

Abstract

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.

Address: Division 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. [email protected].; William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK.; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK.; William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK.; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK.; Semmelweis University, Heart and Vascular Center, Budapest, Hungary.; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.; Division 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.; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK.; Perspectum Ltd., Gemini One, Oxford, UK.; Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK.; Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK.; Department of Experimental Psychology, University of Oxford, Oxford, UK.; Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, Oxford, UK.; William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, UK.; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK.; Health Data Research UK, London, UK.; Alan Turing Institute, London, UK.; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.; Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, Oxford, UK.

DOI: 10.1186/s12916-023-03187-w

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MeSH Terms: Humans, Cohort Studies, Prospective Studies, Biological Specimen Banks, State Medicine, UK Biobank, Hypercholesterolemia, Hypertension, Renal Insufficiency, Chronic, Cholesterol