一项随机试验研究了常规健康检查 24 年后的心血管发病率和全因死亡率：埃贝托夫特健康促进项目（EHPP）。

A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP).

机构信息

Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, Denmark

Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.

出版信息

BMJ Open. 2019 Oct 28;9(10):e030400. doi: 10.1136/bmjopen-2019-030400.

INTRODUCTION

Global prevalence of risk factors for cardiovascular disease (CVD) and all-cause mortality is increasing. Treatments are available but can only be implemented if individuals at risk are identified. General health checks have been suggested to facilitate this process.

OBJECTIVES

To examine the long-term effect of population-based general health checks on CVD and all-cause mortality.

DESIGN AND SETTING

The Ebeltoft Health Promotion Project (EHPP) is a parallel randomised controlled trial in a Danish primary care setting.

PARTICIPANTS

The EHPP enrolled individuals registered in the Civil Registration System as (1) inhabitants of Ebeltoft municipality, (2) registered with a general practitioner (GP) participating in the study and (3) aged 30-49 on 1 January 1991. A total of 3464 individuals were randomised as invitees (n=2000) or non-invitees (n=1464). Of the invitees, 493 declined. As an external control group, we included 1 511 498 Danes living outside the municipality of Ebeltoft.

INTERVENTIONS

Invitees were offered a general health check and, if test-results were abnormal, recommended a 15-45 min consultation with their GP. Non-invitees in Ebeltoft received a questionnaire at baseline and were offered a general health check at year 5. The external control group, that is, the remaining Danish population, received routine care only.

OUTCOME MEASURES

HRs for CVD and all-cause mortality.

RESULTS

Every individual randomised was analysed. When comparing invitees to non-invitees within the municipality of Ebeltoft, we found no significant effect of general health checks on CVD (HR=1.11 (0.88; 1.41)) or all-cause mortality (HR=0.93 (0.75; 1.16)). When comparing invitees to the remaining Danish population, we found similar results for CVD (adjusted HR=0.99 (0.86; 1.13)) and all-cause mortality (adjusted HR=0.96 (0.85; 1.09)).

CONCLUSION

We found no effect of general health checks offered to the general population on CVD or all-cause mortality.

TRIAL REGISTRATION NUMBER

NCT00145782; 2015-57-0002; 62908, 187.

简介

全球心血管疾病（CVD）和全因死亡率的风险因素患病率正在上升。尽管有治疗方法，但只有在识别出有风险的个体后才能实施这些治疗。因此有人提出进行常规健康检查以促进这一进程。

目的

研究基于人群的常规健康检查对 CVD 和全因死亡率的长期影响。

设计和设置

埃贝托夫特健康促进项目（EHPP）是在丹麦基层医疗环境中进行的一项平行随机对照试验。

参与者

EHPP 纳入了在民事登记系统中登记为（1）埃贝托夫特市居民，（2）参与研究的全科医生注册患者，（3）1991 年 1 月 1 日年龄为 30-49 岁的个体。共有 3464 名个体被随机分配为受邀者（n=2000）或非受邀者（n=1464）。受邀者中有 493 人拒绝参加。作为外部对照组，我们纳入了居住在埃贝托夫特市以外的 1511498 名丹麦人。

干预措施

受邀者接受了常规健康检查，如果检查结果异常，则建议与他们的全科医生进行 15-45 分钟的咨询。埃贝托夫特的非受邀者在基线时接受了问卷调查，并在第 5 年接受了常规健康检查。外部对照组，即剩余的丹麦人群，仅接受常规护理。

结局指标

CVD 和全因死亡率的 HRs。

结果

对随机分配的每位个体进行了分析。当比较埃贝托夫特市的受邀者和非受邀者时，我们未发现常规健康检查对 CVD（HR=1.11（0.88；1.41））或全因死亡率（HR=0.93（0.75；1.16））有显著影响。当比较受邀者与剩余的丹麦人群时，我们发现 CVD（调整后的 HR=0.99（0.86；1.13））和全因死亡率（调整后的 HR=0.96（0.85；1.09））的结果也相似。

结论

我们发现，为普通人群提供的常规健康检查对 CVD 或全因死亡率没有影响。

试验注册号

NCT00145782；2015-57-0002；62908,187。