Fortysomethings’ non-attendance at NHS Health Checks raises concerns, says study
pharmafile | October 11, 2026 | Feature | | Chronic Diseases, NHS, Oncology, cardiovascular disease, survey
People in their forties account for almost three-quarters of those who do not attend NHS Health Checks, highlighting the challenge of engaging them in disease prevention, according to a large-scale analysis of NHS data.
Researchers at Imperial College London’s Health Impact Lab examined anonymised records for 925,072 people eligible for an NHS Health Check between 2015 and 2025. Fewer than half (48%) attended.
The analysis, supported by the British Heart Foundation (BHF) and Cabinet Office, found that people who did not attend a Health Check had a 31% higher risk of dying from any cause and a 9% higher risk of experiencing a first non-fatal heart attack or stroke than those who attended.
This disparity in attendance was particularly marked among younger eligible adults. Almost 76% of non-attendees were aged 40–49, compared with 16% aged 50–59, just over 7% aged 60–69 and less than 2% aged 70–74. Men accounted for 60% of those who did not attend.
These findings highlight a key challenge for preventive healthcare: reaching people who may have no symptoms and may not yet consider themselves at risk.
NHS Health Check is offered every five years to people in England aged 40–74 without certain pre-existing conditions. The assessment includes blood pressure, weight and cholesterol checks and an evaluation of cardiovascular risk, including the risk of coronary heart disease and stroke, as well as related conditions such as type 2 diabetes.
Imperial’s study illustrates the potential for such checks to identify conditions before they cause symptoms. Among those attending in North West London, 7,806 people were found to have high blood pressure within 30 days of their check-up, while 4,587 were diagnosed with type 2 diabetes. A further 36,655 were identified as having at least a 10% risk of developing cardiovascular disease over the following decade.
Importantly, identification could lead to intervention. Some 55% of people found to have high blood pressure had reduced it to healthy levels within six months of their Health Check, it was reported.
Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, said Health Checks could give people the opportunity to take action before serious health problems develop.
The researchers now want to identify better ways of reaching people who currently miss out, including changes to invitation letters, digital reminders and offering Health Checks in alternative settings or at a wider range of times.
Dr Federica Re, Innovate MD Clinical Research Fellow at Imperial College London’s Health Impact Lab, said the findings highlighted an opportunity to make Health Checks more effective by using linked NHS data to understand who is being missed and make prevention more personalised and accessible.
This research may bolster calls for prevention strategies that identify cardiovascular risk earlier, but also highlights the practical challenge for primary care, of finding and engaging people before elevated risk becomes established disease.
The Imperial College London study was formally presented at the recent European Society of Cardiology (ESC) Congress hosted in Munich in August.
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