Robson John, Dostal Isabel, Sheikh Aziz, Eldridge Sandra, Madurasinghe Vichithranie, Griffiths Chris, Coupland Carol, Hippisley-Cox Julia
Centre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
BMJ Open. 2016 Jan 13;6(1):e008840. doi: 10.1136/bmjopen-2015-008840.
To describe implementation of a new national preventive programme to reduce cardiovascular morbidity.
Observational study over 4 years (April 2009--March 2013).
655 general practices across England from the QResearch database.
Eligible adults aged 40-74 years including attendees at a National Health Service (NHS) Health Check.
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.
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.
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.
描述一项旨在降低心血管疾病发病率的新的全国性预防计划的实施情况。
为期4年（2009年4月至2013年3月）的观察性研究。
来自QResearch数据库的英格兰各地655家普通诊所。
年龄在40 - 74岁的符合条件的成年人，包括参加国民健康服务（NHS）健康检查的人员。
NHS健康检查：进行常规结构化心血管检查，支持行为改变，对风险最高的人群，治疗危险因素和新发现的合并症。
在168万符合NHS健康检查条件的人群中，2009 - 2012年期间有214295人参加。随着计划的推进，参与人数翻了两番；从2010年的5.8%增至2012年的30.1%。老年人的参与率相对较高，60 - 74岁符合条件的人群中有19.6%参加，40 - 59岁的人群中有9.0%参加。心血管疾病（CVD）风险较高的人群组，如社会经济地位较低的人群（14.9%）的参与率高于较富裕人群（12.3%）。在参加者中，发现了7844例高血压新病例（每1000次检查中有38例）、1934例2型糖尿病新病例（每1000次检查中有9例）和807例慢性肾病新病例（每1000次检查中有4例）。在参加NHS健康检查时被发现心血管疾病风险高（10年风险为20%或更高）的27624人中，19.3%（5325人）新开了他汀类药物处方，8.8%（2438人）新开了抗高血压治疗药物处方。
NHS健康检查的覆盖范围低于预期，但呈逐年改善趋势。新发现的合并症是NHS健康检查的一个重要特征。在全国范围内，对每5名心血管疾病风险最高的参加者中的1人进行他汀类药物治疗，可能有助于大幅降低他们的心血管疾病事件。
