The NHS "MOT" health check to spot signs of illness only has marginal benefits, a Department of Health-funded study has found.
Experts found the programme only prevented the equivalent of one heart attack or stroke for every 4,762 people who attend a health check in a year.
The scheme, which sees people aged 40 to 74 invited for a check with their GP every five years, is reported to cost around £300m per year.
In 2013, the Royal College of GPs branded the checks a "waste of money" while 2012 research from the respected Cochrane group found they did not reduce deaths.
In contrast, a study from Queen Mary University earlier this year said at least 2,500 people would have avoided a heart attack or stroke in the first five years of the programme.
Launched in 2009, the initiative is designed to spot conditions such as heart disease, stroke and diabetes by looking for "silent" factors such as high blood pressure and cholesterol.
The new study, commissioned and funded by the Policy Research Programme at the Department of Health, was published in the Canadian Medical Association Journal.
It used GP records for more than 138,000 patients registered at 462 practices across England from 2009 to 2013.
Researchers found that 21% of the eligible population attended a health check.
When compared with people who had not turned up for a check, having a check only reduced the 10-year risk of suffering cardiovascular disease by 0.21%, researchers said.
There were very small improvements in blood pressure, cholesterol levels and lowering people's weight. There was no increase in the number of people who stopped smoking.
The health checks resulted in a 3% rise in the number of people diagnosed with high blood pressure, and 1.31% rise in the number diagnosed with diabetes.
Kiara Chang, lead author of the research from the School of Public Health at Imperial College London, said: "Cardiovascular disease is the leading cause of death across the world - and so we urgently need effective initiatives to tackle the condition.
"However, these findings suggest the NHS health check scheme offers very modest benefits."
During the health check, people are asked detailed questions and given a cholesterol test, a blood test, are weighed and have their risk of diabetes assessed.
GPs, who are rewarded for carrying out the check, discuss the results with a patient and may prescribe drugs if necessary, including statins to lower cholesterol.
During the latest study, statins were prescribed to 40% of people deemed at high risk of cardiovascular disease.
Ms Chang said this was way below national targets, adding: "Not only are very few people attending the appointments, but the results suggest that among those who do undergo the check, the number of high-risk patients placed on statins is below national guidelines.
"The National Institute for Health and Care Excellence (Nice) guidance suggests all people deemed at high risk of cardiovascular disease should be considered for statins, and the Department of Health suggests 85% uptake of statins is required for the NHS Health Check programme to be cost-effective."
Professor Azeem Majeed, principal investigator of the study from the School of Public Health at Imperial, said: "For the NHS health check scheme to be effective, it needs to be better planned and implemented - our work will help highlight how this can be done.
"In future, we plan to evaluate whether particular groups - for instance older patients - have greater health benefits from the check than younger patients.
"It would also be interesting to investigate the reasons why the health check produced such modest benefits. For instance, to evaluate the advice patients are given during the health check."
Jamie Waterall, national lead for the check at Public Health England (PHE), said: "It is important that we review all emerging evidence for this programme. PHE has an established expert group which will look at the findings of this study.
"The largest national evaluation of the programme shows that the NHS Health Check could have prevented 2,500 heart attacks and strokes in its first five years due to clinical treatments following the check.
"We know that more people could benefit from the check and we are working with local teams to deliver the best possible service."