Instead, the guidelines suggest that a risk assessment may be considered in adult men over 40 years old and in women over 50 years of age or post-menopausal women in specific circumstances, namely if the person requests it, if risk factors such as smoking, overweight, or hyperlipidaemia are present, if there is a family histoiy of premature CVD or of major risk factors such as hyperlipidaemia or if there are symptoms suggestive of CVD (Perk et al., Importantly, the guidelines recommend that risk is assessed on the basis of age, sex, smoking status, blood pressure and total cholesterol - rendering some of the elements offered in the Czech programme, such as the electrocardiogram, unnecessary. The Cochrane Collaboration, in a meta-analysis of 16 large randomised trials with long follow up periods, found that similar health checks no effect on mortality from all causes (risk ratio 0.99, 95% Cl 0.95 to 1.03), cancer (1.01, 95% Cl 0.92 to 1.12), or cardiovascular disease (1.03, 95% Cl 95% Cl 0.91 to 1.17) and did not prevent disease (Krogsboll et al.,