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

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 examin...

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Main Authors: Martin Bernstorff, Pia Deichgræber, Niels Henrik Bruun, Else-Marie Dalsgaard, Morten Fenger-Grøn, Torsten Lauritzen
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e030400.full
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author Martin Bernstorff
Pia Deichgræber
Niels Henrik Bruun
Else-Marie Dalsgaard
Morten Fenger-Grøn
Torsten Lauritzen
author_facet Martin Bernstorff
Pia Deichgræber
Niels Henrik Bruun
Else-Marie Dalsgaard
Morten Fenger-Grøn
Torsten Lauritzen
author_sort Martin Bernstorff
collection DOAJ
description 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.
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spelling doaj-art-192646827cd24f2f9ff947e742af415d2024-12-13T18:55:12ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-030400A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)Martin Bernstorff0Pia Deichgræber1Niels Henrik Bruun2Else-Marie Dalsgaard3Morten Fenger-Grøn4Torsten Lauritzen51 Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, Denmark2 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark1 Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, DenmarkSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, DenmarkResearch Unit for General Practice, Aarhus, Midtjylland, Denmark1 Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, DenmarkIntroduction 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.https://bmjopen.bmj.com/content/9/10/e030400.full
spellingShingle Martin Bernstorff
Pia Deichgræber
Niels Henrik Bruun
Else-Marie Dalsgaard
Morten Fenger-Grøn
Torsten Lauritzen
A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)
BMJ Open
title A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)
title_full A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)
title_fullStr A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)
title_full_unstemmed A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)
title_short A Randomised Trial Examining Cardiovascular Morbidity and All-Cause Mortality 24 years Following General Health Checks: the Ebeltoft Health Promotion Project (EHPP)
title_sort randomised trial examining cardiovascular morbidity and all cause mortality 24 years following general health checks the ebeltoft health promotion project ehpp
url https://bmjopen.bmj.com/content/9/10/e030400.full
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