Whether health checkups favorably impact the occurrence of atherosclerotic cardiovascular
disease (ASCVD) and all-cause mortality in the general population remains in debate.
We investigated further the impact of health checkups on hard ASCVD events and all-cause
mortality. We compared the occurrence of hard ASCVD events and all-cause deaths for
4 years starting in 2010 between participants who used the National Health Checkup
Service (NHCS) more than twice and nonparticipants who never used the NHCS from 2006
to 2009. From the 342,594 survivors aged 40 to 69 years old in 2006 listed in the
National Health Insurance Service-National Sample Cohort, a total of 55,275 pairs
were selected by propensity matching. Hard ASCVD events were defined as the composite
of myocardial infarction and stroke. In the 55,275 matched pairs, we found a significant
association between the use of the NHCS and the reduction in hard ASCVD events (adjusted
hazard ratio = 0.84, 95% confidence interval 0.76 to 0.92, p <0.001) and all-cause
deaths (adjusted hazard ratio = 0.50, 95% confidence interval 0.45 to 0.55, p <0.001).
The participants had more medical care, including outpatient care and hospitalizations,
and took more hypertension and dyslipidemia medications, whereas hospitalizations
for more than 60 days were significantly more frequent in the nonparticipants. In
the subgroup analysis, the reduction in hard ASCVD events for NHCS participants was
significantly greater in patients without a previous history of dyslipidemia or who
did not have outpatient care. In conclusion, the use of the NHCS was significantly
associated with reduced hard ASCVD events and all-cause mortality in the general population.
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Article info
Publication history
Published online: August 07, 2017
Accepted:
July 20,
2017
Received:
June 7,
2017
Footnotes
See page 1811 for disclosure information.
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Copyright
© 2017 Elsevier Inc. All rights reserved.
