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Attending NHS Health Check linked to ‘significantly lower risk of disease’

Attending NHS Health Check linked to ‘significantly lower risk of disease’

Attending an NHS Health Check is associated with a lower risk of both death and several diseases, according to a new study.

An observational study using UK Biobank participants, published today, found that among those who took up an NHS Health check there was a 19% lower rate of dementia diagnosis and 23% lower risk of death from any cause. 

The researchers investigated associations between attending the Health Check appointment at their GP practice and the risk of death or future diagnosis of 14 different health conditions. 

Out of 97,204 total participants, half of them took up the check between 2008 and 2016, and they were each matched with a participant in the control group who did not attend but who shared very similar characteristics, including socio-demographic, lifestyle and medical factors.

All participants were followed up over an average of nine years, and modelling was used to compare outcome rates between the two groups. 

The authors found that in the immediate two years following the NHS Health Check, there were higher diagnosis rates for hypertension, high cholesterol, and chronic kidney disease among recipients compared to the control group.

However, they found that after the longer nine-year follow-up period, recipients of the Health Check had ‘significantly lower risk across all multiorgan disease outcomes and reduced rates of cardiovascular and all-cause mortality’.

Other findings for study participants who attended the check:

  • 19% lower rate of dementia diagnosis
  • 23% lower rate of acute kidney injury diagnosis
  • 44% lower rate of liver cirrhosis diagnosis
  • 23% lower risk of death from any cause
  • 23% lower risk of cardiovascular mortality

The authors said these lower rates ‘may be attributed to risk modification through earlier detection and treatment of key risk factors such as hypertension and high cholesterol’.

They also said that while the Health Check is only a 15-minute appointment, it ‘sets up a relationship’ with the GP team, which ‘may not otherwise occur in ostensibly healthy people’.

The NHS Health Check is offered to adults aged between 40 and 74 and is geared towards identifying those at risk of heart disease, stroke, diabetes, and kidney disease. 

GP teams conduct a basic health check and behaviour survey, and attendees are followed up with tailored support aimed at preventing the onset of these health conditions. 

Previous research has found that the check is linked to higher diagnosis rates in the short term.

The authors said: ‘Our findings corroborate these observations in a much larger independent cohort by demonstrating an increased diagnosis of incident hypertension, high cholesterol, and chronic kidney disease in the immediate period after the NHS Health Check. 

‘These conditions are typically asymptomatic with a long pre-clinical phase. As such, they are almost always identified through screening or opportunistic diagnosis.

‘The longer follow-up duration in our study enabled us to extend existing knowledge by demonstrating that this apparent increase in diagnosis is confined to the first two years after the NHS Health Check, after which the risk of incident health events is significantly lower in recipients.’

Dr Mariam Molokhia, associate professor in epidemiology and primary care at King’s College London, told Pulse the study ‘really shows the importance of preventative medicine’ but also that there needs to be a focus on ‘targeting underserved groups’.

‘I think we are seeing quite stark differential uptake in health checks across a number of co-variates, and these remain after adjustment for patient and practice-level factors. I think better measures of social determinants of health and practice context are needed,’ she said.

Dr Molokhia pointed to biases within the study, which the authors highlighted themselves: ‘The Biobank is very strongly biased to a white population, they don’t have much ethnic diversity. As the authors say, there’s a very strong selection bias.

‘Firstly for participants who actually take up the Biobank – so we know the Biobank have a recruitment rate of about 10%. So the people that do participate are obviously very positively health-motivated.

‘And we know also that people that take up health checks are more likely to be interested in their health than the general population, just because they’re the ones that respond proactively to the invitations.’

However, she said the health check is useful for picking up long-term conditions and other health concerns, and it ‘may support individuals to seek further engagement with their GP’.

At the Spring Budget last year, the Government confirmed that the check will go digital, following a pilot launched in Cornwall in 2022.

In November, a health minister revealed that GPs could be mandated to screen women for menopause within the NHS Health Check.


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Please note, only GPs are permitted to add comments to articles

Michael Mullineux 23 January, 2024 4:18 pm

What an utterly pointless study precis by stating those that are concerned about their health, look after themselves by drinking safely, not smoking and getting a bit of exercise and attend (spurious) medical examinations live longer – go figure.

Nick Mann 23 January, 2024 5:06 pm

The authors can’t seriously expect these effects to be as a result of the intervention. First glance (19% reduction in dementia) tells you that this is simply the healthy user effect writ large. The conclusion of such a study can only correctly be that NHS Healthchecks are targeting exactly the wrong cohort in the first place. What is happening to proper research?

Dave Haddock 23 January, 2024 8:57 pm

Why is so much academic research in GP utter ordure?

paul cundy 24 January, 2024 7:55 am

Dear All,
What an utter waste of time and effort. This has been known for ages. People who respond to invites for checks are healthier. Who’d have guessed it? Mr health freak gets an invite, are they likely to accept whereas when couch potato lager swilling pizza gobbling lardy gets his, how likely do you think he is to think what a great idea. This has been shown in research many years ago. All they have done is shown that the wall painted white ten years ago is still white. As others have pointed out these gains precede the check, they are not a result of the checks.
What they should concentrate on are the unintended consequences of offering healthy people checks to confirm they are healthy. Research has shown that people who attend for checks subsequently consult more frequently than they did before, so the checking process in some way makes them feel they need to be checked to confirm they continue to be healthy.
Which is why wholesale population checking is actually harmful to the system because it results in more resource being wasted on those who don’t need it.
NHS Health Checks have been roundly and repeatedly shown to be an absolute waste of time, effort and money. Whats needed are targeted interventions. Send someone round to visit that couch potato instead.

Mark Howson 24 January, 2024 9:38 am

100% of people who believe correlation means causation will die.

George Forrest 24 January, 2024 3:04 pm

‘Attending’ is the key word here. Not necessarily ‘Heath Check’
The most health-motivated group within the top 10% health-motivated group who registered with the UK Biobank attended an NHS Health Check (and lots of other health related assessments over the following 9 years).
This group also seems to have better health outcomes over a wide range of conditions.
The suggestion that the Health Check caused this behaviour seems much less likely than this behaviour simply being common to the group.
The headline should probably read: Attending to your health linked to ‘significantly lower risk of disease’
Or even: Being able to attend to your health linked to “significantly lower risk of disease”