Free cholesterol tests on the NHS are great – but here’s the five-point health MOT I’d really like to see | Devi Sridhar

You could be walking around symptom-free and not know you’re pre-diabetic, living with hypertension or at a high risk of a heart attack

Prof Devi Sridhar is chair of global public health at the University of Edinburgh

“A n ounce of prevention is worth a pound of cure,” Benjamin Franklin’s adage goes. Yet that simple prescription has been hard to follow in the current NHS. As has been frequently highlighted , one of the biggest challenges for the health system is not just how much we spend per capita, but where and when it is spent. In England, there has been an ongoing shift within the NHS budget towards acute hospital care – treating people in hospitals, often after they are already quite ill – while funding for primary care such as GPs has fallen.

The consequence is that the NHS is increasingly paying for serious and expensive disease treatment, rather than investing upstream to prevent disease in the first place. We spend heavily on dealing with heart attacks, strokes and other life-threatening conditions, rather than identifying those who are at higher risk and intervening earlier to reduce their chances of getting ill.

So, it’s excellent news that the NHS in England will begin to offer free cholesterol tests, and the offer of a blood pressure check, in participating high street pharmacies for those aged 40 to 84. The nationwide phased rollout follows a pilot study in north London in which close to 2,500 patients were checked across 61 community pharmacies. Nineteen percent were found to be at high risk of a heart attack or stroke and were offered advice or referred for medical treatment.

I think it’s a brilliant policy move: it is convenient, relatively inexpensive, takes pressure off GPs and hospitalsand, most importantly, can reduce preventable suffering and deaths. From decades of population-level studies, we have solid data on the factors that can help us predict the risk of serious conditions such as heart disease, type 2 diabetes and some cancers.

There are a staggering number of health tests available (and many that are advertised to us by private companies touting “health checkups”). But I’d say (combining my public health and personal trainer backgrounds) that a small number of low-cost, simple measurements and tests are enough to provide a really useful snapshot of health status and indicate whether intervention is required, either through lifestyle change or medical support. It wouldn’t take much to offer an annual health MOT in community pharmacies.

I’d start with blood pressure: a simple test reveals how much pressure circulating blood is putting on the walls of the arteries and the cardiovascular system. Hypertension (high blood pressure) is often called the silent killer because you can feel perfectly fine while internal damage is accumulating.

Next I’d say a simple waist circumference measurement. This isn’t anything to do with how you look, but rather that where we store fat matters for our health, perhaps more than how much we weigh. Visceral fat, fat around our organs in the abdomen, is associated with high blood pressure, insulin resistance (linked to type 2 diabetes) and heart disease.