title: Effects of invitation to participate in health surveys on the incidence of cardiovascular disease: a randomized general population study.
abstract: The effects of health checks on reducing cardiovascular disease morbidity and mortality in the general population have been questioned. There are few randomized studies with long-term follow-up. We used a cohort randomly selected from a general population as a randomized trial to study the effect of repeated general health checks on the 30-year incidence of ischaemic heart disease (IHD), stroke and all-cause mortality.
  
  
  
  The study included all persons ( n = 17 845) aged 30, 40, 50 and 60 years living in 11 municipalities in Copenhagen, the capital of Denmark. An age- and gender-stratified random sample ( n = 4789) was invited to up to three health checks, from 1982 to 1994 (intervention group). The remaining 12 994 persons were defined as the control group. Complete follow-up on mortality, emigration and fatal and non-fatal IHD and stroke until 31 December 2012 was obtained by linkage to registries.
  
  
  
  There were 3209 and 2190 incident cases of IHD and stroke, respectively, and a total of 6432 deaths during follow-up (mean = 25.2 years). The hazard ratios (HRs) (95% confidence intervals, CIs) for persons in the intervention group versus persons in the control group were as follows: IHD (HR: 0.99, 95% CI: 0.92, 1.07), stroke (HR: 1.14, 95% CI: 1.04, 1.25) and all-cause mortality (HR: 1.03, 95% CI: 0.98, 1.09).
  
  
  
  Repeated general health checks offered to the general population had no beneficial effects on the development of IHD, stroke or all-cause mortality during 30 years of follow-up. An increased incidence of stroke was observed in the group offered health checks.
authors.affiliation: Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.
authors.forename: Tea
authors.initials: T
authors.lastname: Skaaby
authors.affiliation: Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.|Department of Public Health, University of Copenhagen, Copenhagen, Denmark.|Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.affiliation: Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.|Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark.|Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Linneberg
mesh_terms: D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D010358:Patient Participation; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*
keywords: Mass screening; cardiovascular diseases; mortality; myocardial ischaemia; physical examination; preventive medicine; stroke