title: Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year.
abstract: OBJECTIVE
  We aimed to assess whether the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program, was associated with reduction in CVD risk in attendees after one year.
  
  
  METHODS
  We extracted data from patients aged 40-74 years, with high estimated CVD risk, who were registered with general practices in a deprived, culturally diverse setting in England. We included 4748 patients at baseline (July 2008-November 2009), with 3712 at follow-up (December 2009-March 2011). We used a pre-post study design to assess changes in global CVD risk, individual CVD risk factors and statin prescription in patients with a complete and partial Health Check.
  
  
  RESULTS
  There were significant reductions in mean CVD risk score (28.2%; 95% confidence interval (CI)=27.3-29.1 to 26.2%; 95% CI, 25.4-27.1), diastolic blood pressure, total cholesterol levels and lipid ratios after one year in patients with a complete Health Check. Statin prescription increased from 14.0% (95% CI=11.9-16.0) to 60.6% (95% CI=57.7-63.5).
  
  
  CONCLUSIONS
  The introduction of NHS Health Check was associated with significant but modest reductions in CVD risk among screened high-risk individuals. Further cost-effectiveness analysis and work accounting for uptake is required to assess whether the program can make significant changes to population health.
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK. macide.artac08@imperial.ac.uk
authors.forename: Macide
authors.initials: M
authors.lastname: Artac
authors.forename: Andrew R H
authors.initials: AR
authors.lastname: Dalton
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
authors.forename: Josip
authors.initials: J
authors.lastname: Car
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D003955:Diagnostic Tests, Routine; D019468:Disease Management; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D015397:Program Evaluation; D018570:Risk Assessment; D013222:State Medicine / Q000592:standards
keywords: BMI; Body mass index; CHD; CI; CKD; CVD; Cardiovascular disease; Chronic kidney disease; Confidence interval; Coronary heart disease; Family practice; JBS2; Joint British Societies 2; NHS; National Health Service; PCT; Primary care trust; Primary prevention; Risk assessment; Screening