title: The NHS Health Check in England: an evaluation of the first 4 years.
abstract: OBJECTIVE
  To describe implementation of a new national preventive programme to reduce cardiovascular morbidity.
  
  
  METHODS
  Observational study over 4 years (April 2009--March 2013).
  
  
  METHODS
  655 general practices across England from the QResearch database.
  
  
  METHODS
  Eligible adults aged 40-74 years including attendees at a National Health Service (NHS) Health Check.
  
  
  METHODS
  NHS Health Check: routine structured cardiovascular check with support for behavioural change and in those at highest risk, treatment of risk factors and newly identified comorbidity.
  
  
  RESULTS
  Of 1.68 million people eligible for an NHS Health Check, 214 295 attended in the period 2009-12. Attendance quadrupled as the programme progressed; 5.8% in 2010 to 30.1% in 2012. Attendance was relatively higher among older people, of whom 19.6% of those eligible at age 60-74 years attended and 9.0% at age 40-59 years. Attendance by population groups at higher cardiovascular disease (CVD) risk, such as the more socially disadvantaged 14.9%, was higher than that of the more affluent 12.3%. Among attendees 7844 new cases of hypertension (38/1000 Checks), 1934 new cases of type 2 diabetes (9/1000 Checks) and 807 new cases of chronic kidney disease (4/1000 Checks) were identified. Of the 27,624 people found to be at high CVD risk (20% or more 10-year risk) when attending an NHS Health Check, 19.3% (5325) were newly prescribed statins and 8.8% (2438) were newly prescribed antihypertensive therapy.
  
  
  CONCLUSIONS
  NHS Health Check coverage was lower than expected but showed year-on-year improvement. Newly identified comorbidities were an important feature of the NHS Health Checks. Statin treatment at national scale for 1 in 5 attendees at highest CVD risk is likely to have contributed to important reductions in their CVD events.
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Robson
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dostal
authors.affiliation: Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
authors.forename: Sandra
authors.initials: S
authors.lastname: Eldridge
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
authors.forename: Vichithranie
authors.initials: V
authors.lastname: Madurasinghe
authors.affiliation: Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Griffiths
authors.affiliation: School of Community Health Sciences, The University of Nottingham, Nottingham, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Coupland
authors.affiliation: School of Community Health Sciences, The University of Nottingham, Nottingham, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Hippisley-Cox
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D042241:Early Diagnosis; D004739:England; D005260:Female; D058006:General Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013222:State Medicine
keywords: Health check; PRIMARY CARE; cardiovascular risk; cardiovascular risk prevention