Health maintenance for adults

Health maintenance, or preventive health care, is an important component of primary care medicine. Studies show health benefits to routine health checks.[1]Si S, Moss JR, Sullivan TR, et al. Effectiveness of general practice-based health checks: a systematic review and meta-analysis. Br J Gen Pract. 2014 Jan;64(618):e47-53. http://bjgp.org/content/64/618/e47 http://www.ncbi.nlm.nih.gov/pubmed/24567582?tool=bestpractice.com [2]Sopcak N, Fernandes C, O'Brien MA, et al. What is a prevention visit? A qualitative study of a structured approach to prevention and screening - the BETTER WISE project. BMC Fam Pract. 2021 Jul 19;22(1):153. https://www.doi.org/10.1186/s12875-021-01503-y http://www.ncbi.nlm.nih.gov/pubmed/34275453?tool=bestpractice.com [3]Krogsbøll LT, Jørgensen KJ, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev. 2019 Jan 31;(1):CD009009. https://www.doi.org/10.1002/14651858.CD009009.pub3 http://www.ncbi.nlm.nih.gov/pubmed/30699470?tool=bestpractice.com [4]Liss DT, Uchida T, Wilkes CL, et al. General health checks in adult primary care: a review. JAMA. 2021 Jun 8;325(22):2294-306. https://jamanetwork.com/journals/jama/article-abstract/2780614 http://www.ncbi.nlm.nih.gov/pubmed/34100866?tool=bestpractice.com

Cardiovascular disease (CVD) is the leading cause of mortality in the US, followed by cancer. The prevalence of CVD (comprising coronary heart disease, heart failure, stroke, and hypertension) in adults ages 20 years or over is 49% overall and increases with age in both males and females.[5]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 Heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001209 http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com The lifetime risk of developing cancer is around 39.5%, with the majority of newly diagnosed cases occurring in those over 55 years of age.[6]Siegel RL, Kimberly DM, Nikita SW, et al. Cancer statistics, 2023. CA Cancer J Clin. Jan 2023;73(1):17-48. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21763#:~:text=In%202023%2C%201%2C958%2C310%20new%20cancer,occur%20in%20the%20United%20States http://www.ncbi.nlm.nih.gov/pubmed/36633525?tool=bestpractice.com ​​[7]Centers for Disease Control and Prevention. United States Cancer Statistics: data visualizations. Cancer statistics at a glance. Jun 2023 [internet publication]. https://www.cdc.gov/cancer/dataviz [8]National Cancer Institute. Understanding cancer: cancer statistics. Sept 2020 [internet publication]. https://www.cancer.gov/about-cancer/understanding/statistics

Prevention and early detection involves periodic screening of risk factors for CVD, cancer, and and other conditions that impact general health, with the goal of intervening and preventing adverse health outcomes.[9]The American Journal of Managed Care. Population health screenings for the prevention of chronic disease progression​. Nov 2019 [internet publication]. https://www.ajmc.com/view/population-health-screenings-for-the-prevention-of-chronic-disease-progression [10]Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e596-646. https://www.doi.org/10.1161/CIR.0000000000000678 http://www.ncbi.nlm.nih.gov/pubmed/30879355?tool=bestpractice.com ​ Specific cancer screening recommendations for average-risk adults are available for breast, cervical, colorectal, lung, and prostate cancers.[11]Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016 Feb 16;164(4):279-96. https://www.doi.org/10.7326/M15-2886 http://www.ncbi.nlm.nih.gov/pubmed/26757170?tool=bestpractice.com [12]US Preventive Services Task Force., Curry SJ, Krist AH, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Aug 21;320(7):674-86. https://www.doi.org/10.1001/jama.2018.10897 http://www.ncbi.nlm.nih.gov/pubmed/30140884?tool=bestpractice.com [13]US Preventive Services Task Force., Davidson KW, Barry MJ, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021 May 18;325(19):1965-77. https://www.doi.org/10.1001/jama.2021.6238 http://www.ncbi.nlm.nih.gov/pubmed/34003218?tool=bestpractice.com [14]United States Preventive Services Task Force. Lung cancer: screening. Mar 2021 [internet publication]. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening [15]United States Preventive Services Task Force. Prostate cancer: screening. May 2018 [internet publication]. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening ​​​​​​

Once a disease or risk factor is detected, appropriate treatment can then be started as early as necessary. Multifactorial lifestyle interventions have been shown to be beneficial in reducing cardiovascular events and/or mortality in patients at high risk of CVD or with established CVD.[16]Blokstra A, van Dis I, Verschuren WM. Efficacy of multifactorial lifestyle interventions in patients with established cardiovascular diseases and high risk groups. Eur J Cardiovasc Nurs. 2012 Mar;11(1):97-104. http://www.ncbi.nlm.nih.gov/pubmed/21130687?tool=bestpractice.com

Recommendations on preventive health care are available from the US Preventive Services Task Force. US Preventive Services Task Force recommendations Opens in new window

Advice regarding appropriate immunizations for adults is available from the Centers for Disease Control and Prevention. CDC: adult immunization schedule Opens in new window ACIP: vaccine-specific recommendations Opens in new window

This topic concerns preventive healthcare for nonpregnant adults. For guidance on routine medical care during the preconception period and in pregnancy, see Routine prenatal care.