Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK.
Prev Med. 2013 Aug;57(2):129-34. doi: 10.1016/j.ypmed.2013.05.002. Epub 2013 May 21.
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.
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.
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).
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.
评估国民保健制度（NHS）健康检查——一种系统的心血管疾病（CVD）风险评估和管理计划——是否与参加者一年后 CVD 风险的降低有关。
我们从英格兰一个贫困、文化多样的环境中登记的 40-74 岁、估计 CVD 风险高的普通患者中提取数据。我们在基线时纳入了 4748 名患者（2008 年 7 月至 2009 年 11 月），随访时纳入了 3712 名患者（2009 年 12 月至 2011 年 3 月）。我们使用前后研究设计来评估完整和部分健康检查患者的总体 CVD 风险、个体 CVD 风险因素和他汀类药物处方的变化。
在接受完整健康检查的患者中，CVD 风险评分的平均值（28.2%；95%置信区间（CI）=27.3-29.1 至 26.2%；95%CI，25.4-27.1）、舒张压、总胆固醇水平和脂质比在一年后均显著降低。他汀类药物的处方从 14.0%（95%CI=11.9-16.0）增加到 60.6%（95%CI=57.7-63.5）。
国民保健制度健康检查的引入与筛查高危人群的 CVD 风险显著但适度降低有关。需要进一步的成本效益分析和考虑参与情况的工作，以评估该计划是否可以对人群健康产生重大影响。
