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2,500 heart attacks and strokes prevented through NHS Health Check

The first major evaluation of the NHS Health Check in England, carried out by Queen Mary University of London (QMUL), has found that the programme is effectively identifying people at risk of developing major cardiovascular incidents.

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The NHS Health Check programme is the first in the world to tackle prevention of heart attacks and strokes by offering a free check to every adult aged 40-74 years. It provides a personal review of the behavioural factors, such as harmful drinking and obesity, that might increase the risk of developing a heart attack or stroke and offers professional advice on lifestyle change and treatment to reduce the risk.

Over the first five years it is estimated that 2,500 cases of heart attack or stroke were prevented through treatments following the check, as well as helping to diagnose commonly linked conditions, including type 2 diabetes, high blood pressure and chronic kidney disease.

The study, published in BMJ Open, also found that those from the most deprived areas and black and minority ethnic groups, who are at greatest risk of cardiovascular disease, are more likely to attend an NHS Health Check. The authors say that this makes a positive step towards tackling health inequalities in England.

Study lead Dr John Robson from QMUL’s Blizard Institute said: “The NHS Health Check programme is the first of its kind anywhere in the world and our study demonstrates a modest but successful start.  We estimate that the programme could help identify 44,000 new cases of hypertension, 10,000 new cases of diabetes and 4,500 new cases of kidney disease in England every year. In the first five years of the programme, an estimated 2,500 people were also prevented from having a stroke or heart attack through treatments following their NHS Health Check.

“Uptake of the programme during the study period showed year-on-year improvement, but much still needs to be done as there is considerable scope for even better coverage.”

By examining data from 655 GP practices with 1.7 million eligible people, the QMUL researchers found that in addition to the 2,500 people avoiding a major cardiovascular incident, the programme has also successfully identified:

• a new case of hypertension in every 27 appointments;
• a new case of diabetes in every 110 appointments;
• a new case of chronic kidney disease in every 265 appointments;
• 14 per cent of attendees referred to lifestyle interventions due to obesity, smoking, alcohol or blood pressure compared to just 6 per cent of those who were referred through standard care;
• Six times more people with high alcohol consumption than those who do not attend, offering brief advice and support.

The latest evidence suggests the programme is most effective at targeting the older end of the eligible population (those aged over 60) and more work is needed to encourage uptake among the younger age group (aged 40-60). However, as cardiovascular risk increases with age, this evidence suggests that the programme is effective in identifying and providing an NHS Health Check for those with the highest risk.

Professor John Newton, Chief Knowledge Officer, Public Health England said: “It’s good to see the clear initial successes highlighted by this comprehensive and robust study of the NHS Health Check programme in its early stages. The evidence shows that the programme is working and working well for its target group, effectively reaching black and minority ethnic groups and people from deprived areas, who are most at risk of their condition being missed or diagnosed too late.”

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