A letter arrives from your GP practice or the local council: you have turned 40 and you are invited to an NHS Health Check. Many people put it aside, and many others wonder whether it is enough on its own. This article explains what the NHS Health Check covers, what the research says about it, and which extra blood tests people often choose from 40, and why.
What the NHS Health Check is
If you live in England, are aged 40 to 74 and do not have a pre-existing health condition, you should be invited to an NHS Health Check by your GP or local council every 5 years. If you think you are eligible and have not been invited, the NHS suggests contacting your GP practice, or your local council if your practice does not offer it.
The check usually takes 20 to 30 minutes and is often done by a pharmacist, a practice nurse or a healthcare assistant. According to the NHS, it usually includes:
- your height, weight and waist measurement;
- a blood pressure test;
- a cholesterol test, and possibly a blood sugar test;
- questions about your family history, smoking, alcohol and physical activity.
You are then given a cardiovascular risk score: your risk of a heart or circulation problem, such as heart disease, stroke, type 2 diabetes or kidney disease, over the next 10 years. The NHS points out that everyone's risk rises with age, so your score may be higher next time even if your results are the same. If you are over 65, you are also told about the symptoms of dementia to look out for.
What the research says about it
Two large UK studies looked at what happened to people after an NHS Health Check. In the UK Biobank, about 48,000 people who had a check were compared with similar people who had not. In the first 2 years, more cases of high blood pressure, high cholesterol and kidney disease were found among those who attended; over about 9 years, they had lower rates of several conditions and of death (McCracken et al., 2024). In an inner London borough with more than 158,000 eligible people, attending at least one check was linked with lower mortality over time (Saund et al., 2026).
Both are observational studies: they show a link, not proof that the check itself made the difference. The lesson for you is practical: a check helps when its results lead to a conversation and a change, not when they sit in a drawer.
Extra blood tests people choose from 40
The NHS Health Check is a good base, but it is not a full blood check-up. These are the additions people most often consider, each with its reason.
A full cholesterol profile
NICE describes a full lipid profile as total cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides, with non-HDL and low-density lipoprotein (LDL) cholesterol calculated from them, and notes that a fasting sample is not required. NICE also recommends a tool called QRISK3 to estimate the 10-year risk of heart attack and stroke in people without heart disease. The heart health profile adds glycated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP), a marker of inflammation.
Blood sugar
The Health Check includes a blood sugar test only possibly. If type 2 diabetes runs in your family, if you carry extra weight around the waist or if you simply want the number, HbA1c shows your average over the last 2 to 3 months. See the diabetes check.
Kidneys and liver
There are usually no symptoms of kidney disease in the early stages (NHS). Creatinine and the estimated glomerular filtration rate (eGFR) come in the same sample as many general profiles, together with liver enzymes such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT). The general health profile covers both.
Vitamin D and thyroid
Vitamin D is best checked in late winter. Thyroid stimulating hormone (TSH) is worth measuring when tiredness, weight or mood change without an obvious reason.
Women and men from 40
Women
The perimenopause often starts in your 40s. NICE says that in otherwise healthy women aged 45 or over with typical symptoms, perimenopause and menopause are identified without laboratory tests, and it advises against tests such as anti-Müllerian hormone (AMH) and oestradiol for this at that age. The useful blood tests look at what changes around it: cholesterol, blood sugar, thyroid and, while you still have periods, iron if they are heavy. Read women's health blood tests and the women 40 to 59 page.
Men
For men, cholesterol, blood sugar and kidneys usually come first. Routine prostate specific antigen (PSA) testing is not offered on the NHS, but men can ask their GP about it, and the GP talks through the benefits and risks first (NHS). There is a risk the result may not be accurate, so it is a decision to make together. Read prostate health and the PSA test and the men 40 to 59 page.
