Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year

Prev Med. 2013 Aug;57(2):129-34. doi: 10.1016/j.ypmed.2013.05.002. Epub 2013 May 21.


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.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / prevention & control
  • Diagnostic Tests, Routine
  • Disease Management
  • England / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • National Health Programs
  • Program Evaluation
  • Risk Assessment
  • State Medicine / standards