Day 252 - 20 May 96 - Page 57
1
2 Q. But, for example, people who have contracted some form of
3 heart disease or high blood pressure become part of the
4 high risk population from that minute on in terms of ----
5 A. Yes, eventually.
6
7 Q. If they do not change their diet it is going to be a
8 particularly high risk?
9 A. Yes, a better example would be overweight.
10
11 Q. Yes, or obesity. We are talking about in this country,
12 millions of people. That is a very high risk.
13
14 MR. JUSTICE BELL: Well, are we, because you have special cases
15 like hypercholesterolemia, you have got people who have
16 high as opposed to moderately raised blood pressure, but
17 they are in general the older part of the population, and
18 it always surprises me when I read what percentage of our
19 population is below the age of thirty, for instance.
20 Still, despite more people living to great age the
21 proportion of the population which is over, say, 55 is
22 still, as I recall, comparatively small. You may correct
23 me on that?
24 A. Yes, that is so, and I think the other point about
25 high risk in relation to different diseases like obesity
26 hypotension, and cholesterol, they are very often the same
27 people because somebody who is grossly obese is likely to
28 be hypotensive with an elevated blood level.
29
30 MR. JUSTICE BELL: So what this paragraph is saying, if we want
31 to improve public health generally do not concentrate on
32 the comparatively small proportion of the population which
33 is high risk because albeit you would want to do well by
34 them it is not going to change the picture as dramatically
35 as it would if you can improve the general health of those
36 who are moderate or small risk. Is that what the gist of
37 it is?
38 A. That is exactly right, and in the end the high
39 proportion, the high risk ground, will decline because you
40 would eliminate it hopefully by intervention at a much
41 earlier stage.
42
43 MR. JUSTICE BELL: So along the way you are going to help the
44 high risk group as well?
45 A. Yes, yes.
46
47 MR. MORRIS: Is it still the case that something like 200,000
48 people die of heart disease in this country every year?
49 A. Well, if that is the figure quoted, yes. I have no
50 reason to dispute that.
51
52 Q. It is not quoted in here. I have seen it quoted in many
53 different places?
54 A. I am sure it must be in the cardiovascular document.
55
56 Q. Well, yes, if we accept that, and we accept something like
57 200,000, subject to a different figure being found, and
58 that is each year. If we call a generation, say, thirty
59 years or something, we are talking about 6 million people
60 in each generation diagnosed of heart disease. Would you
