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

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