In short
A twelve month structure for people whose main constraint is time, not motivation. Three appointments, not twelve.
- Month 0. History, examination, a justified panel, calculated risk, and a decision on medication
- Month 3. Whether the changes and any medication are working. Blood pressure and weight move first
- Month 12. Recalculation, screening due, and the interval for the next year
More frequent is not better. General health checks in randomised trials did not reduce mortality, so the value sits in the decisions, not the appointments.
Treatment Overview
Why three appointments and not a monthly programme?
Because there is no evidence base for an optimal check up frequency, and more frequent testing mostly generates borderline results that need chasing.
In a meta analysis of 14 randomised trials covering over 180,000 people, general health checks did not reduce total, cardiovascular or cancer mortality. They did improve blood pressure, cholesterol and BMI, particularly in higher risk people. The benefit is in acting, not in attending.
What the twelve months contain
| Month 0 | Full history including family history with ages, examination, blood pressure taken properly, justified panel, calculated 10 year and where relevant 30 year risk, and a decision on treatment |
| Month 3 | Response to any medication started, blood pressure and weight rechecked, activity progress, and adjustment |
| Month 12 | Risk recalculated, screening due for your age, and the review interval set for the following year |
Why blood pressure and weight are checked first
Because they move fastest and they feed directly into the risk calculation. Lipids and glucose take longer to shift and are rechecked where they were abnormal.
Blood pressure is also confirmed outside the clinic before any diagnosis of hypertension is made, which matters more in a group where a rushed clinic reading is likely to be misleading.
What is specific to executive risk?
- Sitting time. Over eight hours a day is an independent mortality risk, and it is worse when uninterrupted rather than broken up
- The travel pattern. Irregular intense exercise is the worst pattern. People who do not exercise regularly are more likely to be badly injured when they do
- Alcohol. Usually the largest single modifiable factor in this group and the one least often asked about directly
- Sleep. Sleep apnoea is common, under diagnosed, and produces exactly the fatigue and concentration picture that gets attributed to workload
Can sitting be offset?
Largely, but not with a token amount. The excess mortality linked to sitting over eight hours a day disappeared in people doing about 300 minutes a week or more of moderate to vigorous activity.
That is roughly 45 minutes a day, which is a schedulable quantity rather than an aspiration.
Who Is a Good Candidate?
- You want structure and have limited time for appointments
- You travel frequently and your routine breaks down for weeks at a time
- You sit for most of the working day
- You have had corporate health checks that produced results but no decisions
- There is early cardiovascular disease or diabetes in your family
- Chest pain or breathlessness on exertion, which needs a diagnostic appointment now
- Snoring with witnessed pauses in breathing, which needs a sleep assessment rather than a longevity programme
- You are looking for a comprehensive scan package, which is not what this is
What Happens During the Consultation
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1
Month 0: the full assessment
History including sitting time, travel pattern, alcohol and sleep. Examination, blood pressure taken properly, and a justified panel with the reason for each test stated before it is ordered.
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2
Month 0: the decision
Calculated risk band, 30 year risk where relevant, and a clear decision on medication either way. Two or three behaviour changes with numbers rather than a list.
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3
Month 3: does it work
Blood pressure and weight rechecked, medication tolerance and effect assessed, activity progress reviewed and the target adjusted. This is where most plans either take or fail.
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4
Month 12: recalculate and reset
Risk recalculated rather than assumed, screening due for your age arranged, and the interval for the next year set: yearly from 50, or every three years below that without chronic conditions.
Program Structure & Follow-Up
What happens between the appointments
Not much by design, which is the point. What is agreed at month 0 is specific enough to run without supervision, and there is one number you track.
What triggers contact outside the schedule
- A side effect from anything started
- A new symptom, particularly on exertion
- A result from elsewhere you want interpreted
- A new diagnosis in a close family member
What happens after year one
| Under 50, no chronic conditions | Review every three years |
| 50 and over | Yearly |
| Any chronic condition | Regular review regardless of age |
| Cardiovascular risk | Every three to five years if low, yearly at borderline or above |
Travelling and continuity
Results and decisions are documented so that another doctor can pick them up, including which calculator was used and which threshold applies to it. Different calculators give materially different answers for the same person, so recording that avoids contradictory advice later.
Benefits, Limits & Safety
What twelve months can realistically change
- Blood pressure and weight, which move within three months
- Lipids, where medication is started
- Activity, where the largest available gain is simply moving from inactive to active
- Smoking, where counselling plus medication has the strongest evidence of any behaviour change in medicine
What it cannot change in twelve months
Your calculated risk will not move dramatically, because age is a large component of it and age only goes one way. What changes is the modifiable part, and that compounds over decades rather than months.
Coronary calcium is not rescanned to demonstrate progress, because progression adds little to what the first scan already said.
What the programme deliberately does not include
- Whole body scans as a routine screen
- Biological age testing
- Growth hormone, unlicensed peptides or IV infusions
- Broad hormone or micronutrient panels ordered without a question
- Screening you are unlikely to benefit from, which is more common in executive packages than anywhere else
An honest note on corporate health checks
They tend to be comprehensive in scope and thin in decisions. The measure of a good check is not how many tests it contained but how many decisions came out of it, and how many things you stopped doing as a result.
Three appointments, three decisions
A risk band and a treatment decision at month 0, an honest check of whether it is working at month 3, and a recalculation at month 12.
What moves first
Blood pressure and weight within three months. Lipids where medication is started. Activity measured by something you will actually track.
Not part of it
Whole body scans, biological age tests, growth hormone, peptides, infusions and undirected broad panels.
Cost & Program Investment
The three consultations and each test are quoted separately before anything is booked, so the twelve month total is known at the start. There is no tiered package, because a more expensive tier would mean more tests rather than better decisions, and more testing has not been shown to improve outcomes. Corporate invoicing is straightforward and the documentation is written so that another doctor can continue the plan.
Frequently Asked Questions
Because there is no evidence for an optimal check up frequency, and more frequent testing mainly produces borderline results that need chasing. Each appointment here is designed to end in a decision.
Usually in the same way: corporate checks tend to be broad in tests and thin in decisions. The useful measure is how many decisions came out of it and how many things it told you to stop.
That is what the structure is for. Everything agreed at month 0 is specific enough to run unsupervised, and the documentation is written so another doctor can pick it up mid year.
No. It is not a routine screen because it mostly finds things that were never going to matter, each of which then has to be excluded.
Usually breaking up sitting and reaching about 300 minutes a week of moderate to vigorous activity, which is the level at which the excess mortality linked to long sitting disappeared. Alcohol is often the second.
Only if your calculated risk band supports it, and you will be given the absolute numbers rather than relative ones. Your own threshold for taking daily medication is a legitimate part of that decision.
The interval is set by your age and risk: yearly from 50, about every three years below that without chronic conditions, and cardiovascular risk every three to five years if low.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
- Ageing and health
- Physical activity
- Cardiovascular diseases
- Cardiovascular disease: risk assessment and reduction
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.