PT  - JOURNAL ARTICLE
AU  - Saund, Jasjot
AU  - Dodhia, Hiten
AU  - Vanoli, Jacopo
AU  - Masselot, Pierre
AU  - O’Neill, Stephen
TI  - Association of the NHS Health Check with all-cause mortality: a longitudinal cohort study in primary care
AID  - 10.3399/BJGP.2025.0451
DP  - 2026 Sep 01
TA  - British Journal of General Practice
PG  - e724--e733
VI  - 76
IP  - 770
4099  - http://bjgp.org/content/76/770/e724.short
4100  - http://bjgp.org/content/76/770/e724.full
SO  - Br J Gen Pract2026 Sep 01; 76
AB  - Background Cardiovascular disease (CVD) prevention is a policy priority because of widening inequalities and increasing preventable deaths. The NHS Health Check (NHS-HC) programme aims to promote early detection and prevention of CVD but has a wider-reaching impact owing to targeting multiple risk factors. Although programme evaluations demonstrate improvements in detection and surrogate markers, research on mortality outcomes remain limited, particularly using representative, real-world data.Aim To evaluate the effectiveness of NHS-HCs in reducing all-cause mortality.Design and setting Longitudinal cohort study in an inner-city London borough.Method Data from electronic primary care records were analysed for 158 645 eligible participants (2009–2023). Survival was modelled using a Cox proportional hazards model with time-varying exposure. All-cause mortality risk was compared between those attending ≥1 NHS-HC (n = 42 589) and those who did not (n = 116 056). Sociodemographic, geographic, and behavioural factors were adjusted using propensity score weighting.Results Of the 158 645 participants, 63 347 (39.9%) were of Black, Asian, mixed, or other ethnicity, and 100 825 (63.6%) lived in the two most deprived quintiles in England. Attendance at ≥1 NHS-HC was associated with lower mortality (adjusted hazard ratio 0.68, 95% confidence interval = 0.63 to 0.74), indicating a 32% reduction in risk. Ten-year absolute mortality risk reduction increased with age, with the largest difference among those aged 70–74 years (18.1% versus 12.9%). Sensitivity analyses supported these findings.Conclusion This study suggests significant long-term survival benefit associated with the NHS-HC, supporting continued investment in and optimisation of the programme to provide population health benefits. Findings were robust to missing data assumptions and COVID-19, although residual confounding cannot be ruled out.