Detection of previously undiagnosed conditions in midlife preventive health examinations

Abstract

Abstract This study aimed to investigate the prevalence of previously undocumented suspected diagnoses identified during preventive health examinations in middle-aged adults, and to examine their associations with clinical and behavioral factors. In this cross-sectional study, 1,040 adults aged 45–59 years underwent preventive clinical examinations comprising self-reported medical histories, anamneses, previous medical records, and laboratory tests (LDL cholesterol, blood pressure, HbA1c, TSH). Suspected diagnoses were defined by clinical thresholds (e.g., LDL > 116 mg/dl, hypertension ≥ 140/90 mmHg, HbA1c > 6.0%). Multivariable logistic regression analyzed associations between multiple variables and the three binary outcomes, any suspected diagnosis of hypertension and elevated cholesterol. The mean age of participants was 52.93 years (sd = 4.17), with 61% male (n = 631). In total, 421 (41%) had at least one newly identified suspected diagnosis. The most frequent findings were elevated LDL cholesterol (n = 287, 28%) and hypertension (n = 93, 9%). Male sex was associated with higher odds of any suspected diagnosis (OR: 1.42; 95%-CI: 1.09–1.85) and having hypertension (OR: 2.24; 95%-CI: 1.31–3.99). BMI was associated with hypertension (OR: 1.15; 95%-CI: 1.08–1.21) and showed a weak association with elevated cholesterol (OR: 1.04; 95%-CI: 1.00–1.08). A recent blood test was linked to lower odds of any suspected findings (OR: 0.65; 95%-CI: 0.50–0.84). No consistent associations were observed for lifestyle factors. A family history of dyslipidemia was associated with elevated cholesterol (OR: 1.55; 95%-CI: 1.01–2.40). Preventive health screenings can reveal a substantial number of previously undiagnosed conditions, particularly among individuals with limited healthcare contact or elevated risk. The findings suggest that such screenings may offer a significant value for targeted risk groups in midlife. Further research should evaluate long-term outcomes and cost-effectiveness.