Day 253 - 21 May 96 - Page 24


     
     1        people but that is the case.  We are not so concerned about
     2        that.  We are concerned about people having heart attacks
     3        at the age of 40"; yes?
     4        A.  Yes.
     5
     6   Q.   Then there were some discussion between you and Ms. Steel
     7        about the prevalence of heart disease in different age
     8        groups in the population; do you remember that?
     9        A.  Yes.
    10
    11   Q.   Can I ask you to look at the COMA book now, not the World
    12        Health Organisation one, number 46, The Nutritional Aspects
    13        of Cardio-vascular Disease, this having been published in
    14        1994, and ask you, first of all, to look at page 42.
    15        I will, if I may, read the text which appears.  Do you have
    16        figures 2.5a and 2.5b?
    17        A.  Yes.
    18
    19   Q.   May I just read the text at 2.1.5.1.  The heading is
    20        "Secular Trends".  What are secular trends, Professor
    21        Naismith?
    22        A.  These are changes with time, changes measured over a
    23        long interval of time.
    24
    25   Q.  "Figures 2.5a to 2.5d show the secular trends in the four
    26        countries of the UK between 1972 and 1989.  Three year
    27        rolling averages have been calculated based on data from
    28        1971 to 1990.  Longer term trends and more detailed
    29        analysis for those aged 35-64 are given in Appendix B.
    30        Figures 2.5a to 2.5b show death rates for females remaining
    31        below those for males throughout the period 1972-1989.  For
    32        CHD, death rates changed little over the period to 1978
    33        with subsequent fall, particularly marked for males under
    34        65.  For stroke (Figures 2.5c and 2.5d) rates fell over the
    35        whole period, with a faster decline in the under 65 groups
    36        than for all ages.  The rates for the different countries
    37        of the UK followed broadly similar patterns.  Death rates
    38        for Scotland and N. Ireland have remained consistently
    39        higher than those in England and Wales."
    40
    41        Can I ask you to look at the figures.  The first two
    42        figures are for males and females under 65; do you see?
    43        A.  Yes.
    44
    45   Q.   Under 2.5a, and one sees that although the graph went up,
    46        generally speaking if I may use that, towards the end of
    47        the 1970s for the under 65s, it showed a more or less
    48        continuous decline since then?
    49        A.  Yes.
    50 
    51   Q.   For the under 65s which was the group you were talking 
    52        about being of particular concern yesterday? 
    53        A.  Yes.
    54
    55   Q.   Can I ask you whether you know, and this ends in 1990,
    56        whether that downward trend has continued in this country?
    57        A.  I think it is likely to continue.  In the Health of the
    58        Nation document produced by the Government, they have
    59        identified targets for these various diseases by the end of
    60        the Century, and I think that if one simply extrapolates

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