Forster Alice S, Dodhia Hiten, Booth Helen, Dregan Alex, Fuller Frances, Miller Jane, Burgess Caroline, McDermott Lisa, Gulliford Martin C
King's College London, London SE1 3QD, UK.
Lambeth-Southwark Public Health Directorate, London SE1 2QH, UK.
J Public Health (Oxf). 2015 Jun;37(2):234-40. doi: 10.1093/pubmed/fdu079. Epub 2014 Oct 17.
This study aimed to evaluate the yield of the NHS Health Checks programme.
A cohort study, conducted in the Clinical Practice Research Datalink in England. Electronic health records were analysed for patients aged 40-74 receiving an NHS Health Check between 2010 and 2013.
There were 65 324 men and 75 032 women receiving a health check. For every 1000 men assessed, there were 205 smokers (95% confidence interval 195-215), 355 (340-369) with hypertension (≥140/90 mmHg) and 633 (607-658) with elevated cholesterol (≥5 mmol/l). Among 1000 women, there were 161 (151-171) smokers, 247 (238-257) with hypertension and 668 (646-689) with elevated cholesterol. In the 12 months following the check, statins were prescribed to 18% of men and 21% of women with ≥20% cardiovascular risk and antihypertensive drugs to 11% of men and 16% of women with ≥20% cardiovascular risk. Slight reductions in risk factor values were observed in the minority of participants with follow-up values recorded in the 15 months following the check.
A universal primary prevention programme identifies substantial risk factor burden in a population without known cardiovascular disease. Research is needed to monitor interventions, and intermediate- and long-term outcomes, in those identified at high risk.
本研究旨在评估国民健康服务(NHS)健康检查计划的成效。
在英国临床实践研究数据链中开展的一项队列研究。对2010年至2013年间接受NHS健康检查的40 - 74岁患者的电子健康记录进行分析。
共有65324名男性和75032名女性接受了健康检查。每1000名接受评估的男性中,有205名吸烟者(95%置信区间195 - 215),355名(340 - 369)患有高血压(收缩压≥140/舒张压≥90 mmHg),633名(607 - 658)胆固醇升高(≥5 mmol/l)。在1000名女性中,有161名(151 - 171)吸烟者,247名(238 - 257)患有高血压,668名(646 - 689)胆固醇升高。在检查后的12个月内,心血管疾病风险≥20%的男性中有18%、女性中有21%被开了他汀类药物,心血管疾病风险≥20%的男性中有11%、女性中有16%被开了抗高血压药物。在检查后15个月有随访记录的少数参与者中,观察到危险因素值略有降低。
一项全民初级预防计划可识别出无已知心血管疾病人群中大量的危险因素负担。需要开展研究以监测对高危人群的干预措施以及中期和长期结果。