Day 252 - 20 May 96 - Page 58


     
     1        accept that?
     2        A.   Yes, yes, people die.
     3
     4   MR. JUSTICE BELL: I am more interested in premature death
     5        because we have all got to die sometime?
     6        A.   Yes.
     7
     8   Q.   And.
     9
    10   MR. MORRIS:  It would be nice to die of old age.
    11
    12   MR. JUSTICE BELL: I know, but you can die of cardiovascular
    13        disease at the age of 88, you see.  No one is pretending
    14        that the proportion of people, or numbers of people, who
    15        die prematurely from cardiovascular disease is less than
    16        cause for concern?
    17        A.   Absolutely, yes.
    18
    19   Q.   But can you help as to proportions of the generation of
    20        things of that kind so far as premature death from
    21        cardiovascular disease is concerned?
    22        A.   Yes, I think this point is made.  If you look back at
    23        this, you may remember the histograms that were shown in
    24        this book of the incidence of cardiovascular disease in
    25        different European countries.  If you also look at the
    26        incidence of cerebral vascular disease what you will note
    27        is in countries that have a low incidence of cardiovascular
    28        disease they have a high incidence of cerebral vascular
    29        disease, and if you add the two together it comes to much
    30        the same.  So it is a question of whether, as a nation, you
    31        prefer to die of heart disease or a stroke.  Portugal is a
    32        good example with a very low incidence of cardiovascular
    33        disease and an extremely incidence of cerebral vascular
    34        disease.  So, the point being that one has to die of
    35        something and while it is possible that one can reduce the
    36        incidence of cardiovascular disease, whether this will in
    37        the end increase longevity in the population on average, we
    38        do not really no.
    39
    40        There have been, as you know, a number of intervention
    41        studies in which almost every risk factor was eliminated
    42        and this had quite a disastrous effect.  I think there was
    43        a higher mortality in that group than in the control group,
    44        a study carried out in Sweden, so I think one has to be
    45        careful about how optimistic one can be about changing
    46        mortality by addressing one particular condition like card
    47        vascular disease.
    48
    49   MS. STEEL:   I do not know where this will be found in the
    50        bundles and there is only one thing I wanted to ask you 
    51        about while we are on this point.  It is in the Health 
    52        Education Council Discussion Paper on proposals for 
    53        nutritional guidelines for Health Education in Britain
    54        prepared for the National Advisory Committee on Nutrition
    55        Education by an ad hoc working party under the chairmanship
    56        of ----.
    57
    58   MR. JUSTICE BELL:   Are we leaving this document now?
    59
    60   MR. MORRIS:  I have finished the book.  We are not sure we are

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