TY - JOUR
T1 - Cardiovascular risk at health checks performed opportunistically or following an invitation letter
T2 - Cohort study
AU - Gulliford, Martin C.
AU - Khoshaba, Bernadette
AU - McDermott, Lisa
AU - Cornelius, Victoria
AU - Ashworth, Mark
AU - Fuller, Frances
AU - Miller, Jane
AU - Dodhia, Hiten
AU - Wright, Alison J.
PY - 2018/6
Y1 - 2018/6
N2 - Background A population-based programme of health checks has been established in England. Participants receive postal invitations through a population-based call-recall system but health check providers may also offer health checks opportunistically. We compared cardiovascular risk scores for euro; opportunistic' health checks. Methods Cohort study of all health checks completed at 18 general practices from July 2013 to June 2015. For each general practice, cardiovascular (CVD) risk scores were compared by source of check and pooled using meta-analysis. Effect estimates were compared by gender, age-group, ethnicity and fifths of deprivation. Results There were 6184 health checks recorded (2280 invited and 3904 opportunistic) with CVD risk scores recorded for 5359 (87%) participants. There were 17.0% of invited checks and 22.2% of opportunistic health checks with CVD risk score ≥10%; a relative increment of 28% (95% confidence interval: 14-44%, P < 0.001). In the most deprived quintile, 15.3% of invited checks and 22.4% of opportunistic checks were associated with elevated CVD risk (adjusted odds ratio: 1.94, 1.37-2.74, P< 0.001). Conclusions Respondents at health checks performed opportunistically are at higher risk of cardiovascular disease than those participating in response to a standard invitation letter, potentially reducing the effect of uptake inequalities.
AB - Background A population-based programme of health checks has been established in England. Participants receive postal invitations through a population-based call-recall system but health check providers may also offer health checks opportunistically. We compared cardiovascular risk scores for euro; opportunistic' health checks. Methods Cohort study of all health checks completed at 18 general practices from July 2013 to June 2015. For each general practice, cardiovascular (CVD) risk scores were compared by source of check and pooled using meta-analysis. Effect estimates were compared by gender, age-group, ethnicity and fifths of deprivation. Results There were 6184 health checks recorded (2280 invited and 3904 opportunistic) with CVD risk scores recorded for 5359 (87%) participants. There were 17.0% of invited checks and 22.2% of opportunistic health checks with CVD risk score ≥10%; a relative increment of 28% (95% confidence interval: 14-44%, P < 0.001). In the most deprived quintile, 15.3% of invited checks and 22.4% of opportunistic checks were associated with elevated CVD risk (adjusted odds ratio: 1.94, 1.37-2.74, P< 0.001). Conclusions Respondents at health checks performed opportunistically are at higher risk of cardiovascular disease than those participating in response to a standard invitation letter, potentially reducing the effect of uptake inequalities.
KW - cardiovascular disease prevention
KW - health check
KW - mass screening methods
KW - primary care
KW - social inequalities
UR - http://www.scopus.com/inward/record.url?scp=85037858363&partnerID=8YFLogxK
U2 - 10.1093/pubmed/fdx068
DO - 10.1093/pubmed/fdx068
M3 - Article
AN - SCOPUS:85037858363
SN - 1741-3842
VL - 40
SP - e151-e156
JO - Journal of Public Health (United Kingdom)
JF - Journal of Public Health (United Kingdom)
IS - 2
ER -
