Institute of Population Health Sciences, Queen Mary University of London, London.
Nuffield Department of Primary Care Health Science, University of Oxford, Oxford.
Br J Gen Pract. 2021 Aug 26;71(710):e701-e710. doi: 10.3399/BJGP.2020.1021. Print 2021 Sep.
The NHS Health Check cardiovascular prevention programme is now 10 years old.
To describe NHS Heath Check attendance, new diagnoses, and treatment in relation to equity indicators.
A nationally representative database derived from 1500 general practices from 2009-2017.
The authors compared NHS Health Check attendance and new diagnoses and treatments by age, sex, ethnic group, and deprivation.
In 2013-2017, 590 218 (16.9%) eligible people aged 40-74 years attended an NHS Health Check and 2 902 598 (83.1%) did not attend. South Asian ethnic groups were most likely to attend compared to others, and females more than males. New diagnoses were more likely in attendees than non-attendees: hypertension 25/1000 in attendees versus 9/1000 in non-attendees; type 2 diabetes 8/1000 versus 3/1000; and chronic kidney disease (CKD) 7/1000 versus 4/1000. In people aged ≥65 years, atrial fibrillation was newly diagnosed in 5/1000 attendees and 3/1000 non-attendees, and for dementia 2/1000 versus 1/1000, respectively. Type 2 diabetes, hypertension, and CKD were more likely in more deprived groups, and in South Asian, Black African, and Black Caribbean ethnic groups. Attendees were more likely to be prescribed statins (26/1000) than non-attendees (8/1000), and antihypertensive medicines (25/1000 versus 13/1000 non-attendees). However, of the 117 963 people with ≥10% CVD risk who were eligible for statins, only 9785 (8.3%) were prescribed them.
Uptake of NHS Health Checks remains low. Attendees were more likely than non-attendees to be diagnosed with type 2 diabetes, hypertension, and CKD, and to receive treatment with statins and antihypertensives. Most attendees received neither treatment nor referral. Of those eligible for statins, <10% were treated. Policy reviews should consider a targeted approach prioritising those at highest CVD risk for face-to-face contact and consider other options for those at lower CVD risk.
国民保健制度（NHS）健康检查心血管预防计划已经实施了 10 年。
描述与公平指标相关的 NHS 健康检查参与情况、新诊断和治疗情况。
从 2009 年至 2017 年，来自 1500 家全科医生的数据中提取的全国代表性数据库。
作者比较了 NHS 健康检查的参与情况以及新诊断和治疗情况，包括年龄、性别、族裔和贫困程度。
2013 年至 2017 年，年龄在 40-74 岁之间的符合条件的 590218 人（16.9%）参加了 NHS 健康检查，而 2902598 人（83.1%）未参加。与其他族裔群体相比，南亚族裔群体更有可能参加，而女性比男性更有可能参加。与未参加者相比，参加者更有可能被诊断出新的疾病：高血压 25/1000 人参加者与 9/1000 人未参加者；2 型糖尿病 8/1000 人与 3/1000 人未参加者；慢性肾脏病（CKD）7/1000 人与 4/1000 人未参加者。在年龄≥65 岁的人群中，新诊断出心房颤动的人数分别为 5/1000 名参加者和 3/1000 名未参加者，痴呆症的新诊断人数分别为 2/1000 名参加者和 1/1000 名未参加者。2 型糖尿病、高血压和 CKD 在贫困程度较高的人群以及南亚、非洲裔黑人以及加勒比黑人族群中更为常见。与未参加者相比，参加者更有可能服用他汀类药物（26/1000）和抗高血压药物（25/1000 人参加者与 13/1000 人未参加者）。然而，在 117963 名具有≥10%心血管疾病风险的人中，只有 8385 人（8.3%）被开了他汀类药物。
NHS 健康检查的参与率仍然很低。与未参加者相比，参加者更有可能被诊断出患有 2 型糖尿病、高血压和 CKD，并且更有可能接受他汀类药物和抗高血压药物治疗。大多数参加者既未接受治疗也未接受转介。在符合他汀类药物治疗条件的人中，只有<10%的人接受了治疗。政策审查应考虑针对具有最高心血管疾病风险的人采取有针对性的方法进行面对面接触，并考虑为风险较低的人提供其他选择。
