Universal Health Checkups and Risk of Incident Diabetes and Hypertension
Authors' conclusion
In this cohort study, within a median of 4.2 years of follow-up, SHC recipients had a 9.8% lower risk of incident diabetes and hypertension (13.8% in the bias-calibrated analysis). The cost-effectiveness of the SHC and its transportability to other regions are unclear, requiring future investigations.
Study context
- Population
- Individuals aged 40 to 74 years without diabetes or hypertension and without prior checkup history, longitudinal health care database, Japan, 2008–2020153,084 unique persons
- Participants
- 78,620 vs 214,554
- Exposure
- Specific Health Checkup participation vs nonparticipation
- Specific Health Checkup (SHC)n = 78,620
- Nonparticipantsn = 214,554reference
- Outcome
- Composite of:
- Incident T2D
- Hypertension (newly documented diagnosis and use of relevant medications)
- Follow-up
- Up to 10 years
Methodological detailstarget trial emulation, sequential cohorts, propensity score-weighted survival analysis, negative outcome control analysis
- Target trial emulation
- Sequential cohorts
- Propensity score-weighted survival analysis
- Negative outcome control analysis
Main finding
As reported in the abstract
Composite:
- Incident T2D
- Hypertension
Each group vs nonparticipantsHazard ratio (95% CI)
SHC
0.90(0.89–0.92)
Each group vs nonparticipantsDifference in cumulative incidence at 10 years (95% CI)
SHC
−1.6%(−1.8% to −1.3%)
- Bias-calibrated HR for the primary outcome
- 0.86 (95% CI, 0.84-0.89)
Observational data: associations, not effects.
Further findings
Sensitivity analyses
- The sensitivity analyses showed similar results
Negative outcome control (depression)
- Negative control analysis suggested potential for residual confounding: HR
- 1.05 (95% CI, 1.02-1.07)
Original publication
Universal Health Checkups and Risk of Incident Diabetes and Hypertension. JAMA Netw Open. Published 2 December 2024. doi:10.
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