title: Prevalence of cardiovascular disease risk amongst the population eligible for the NHS Health Check Programme.
abstract: BACKGROUND
  The National Health Service (NHS) Health Check Programme aims to identify and manage patients in England aged 40-74 years with a 10-year cardiovascular disease (CVD) risk score over 20%. We aimed to assess the prevalence of high CVD risk in the English population, using the two CVD risk scores and the 20% cut off mandated in national policy, and the prevalence of risk factors within this population.
  
  
  METHODS
  Modelling study using patients registered in general practice in England.
  
  
  METHODS
  Using data from the Health Survey for England, we modelled the prevalence of high CVD risk in general practice populations.
  
  
  RESULTS
  Of those eligible for an NHS Health Check, 10.5% (2,012,000) had a risk score greater than 20% using the QRISK2 risk score; 22.0% (4,267,000) using Joint British Societies' (JBS2) score. There was a median of 206 (range 0-1693) and 447 (0-3321) patients per practice at high risk respectively, with wide geographic variation. Within the high-risk population, there was a high prevalence of CVD risk factors; in the QRISK2 population, for example 82.6% were physically inactive. To reduce risk in those at high CVD risk, we estimate the total costs of the Programme to be £176 million using QRISK2 or £378 million using JBS2.
  
  
  CONCLUSIONS
  A large number of high-risk patients will be identified by the Programme; health service commissioners must ensure the adequate provision and the targeted allocation of risk reduction services for the Programme to be effective. The NHS must consider whether extra costs using JBS2 are warranted. The Programme must be fully monitored to ensure its cost effectiveness and appropriate outcomes such as the numbers at high risk assessed.
authors: Faculty of Medicine, Imperial College, London UK. NHS Ealing, Southall, UK. andrew.dalton07@imperial.ac.uk
authors: Andrew R H
authors: AR
authors: Dalton
authors: Michael
authors: M
authors: Soljak
authors: Edgar
authors: E
authors: Samarasundera
authors: Christopher
authors: C
authors: Millett
authors: Azeem
authors: A
authors: Majeed
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D058006:General Practice / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors