Mant1 acknowledges the pressing need for earlier identification of cardiovascular (CVD) risk, hypertension, diabetes, and kidney disease (CKD). He identifies some questions raised by recent research but underlines that evidence is inconsistent. He suggests that the NHS Health Check should be abandoned, but offers little alternative beyond usual primary care. We would challenge that an approach dependent on the status quo can be justified when, despite almost universal registration with a GP, around 5 million people in England have undiagnosed hypertension, 1.6 million have undiagnosed CKD and 700 000 undiagnosed diabetes.
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