Day 252 - 20 May 96 - Page 33
1 CHD at 40 years and a 19 percent reduction at 80 years.
2 In older people the relative risk may be less in part
3 because of lifestyle changes and premature CHD death among
4 the most susceptible."
5
6 Would you agree with what is written there, the parts that
7 I have read out?
8 A. Yes, that seems to be a reasonable analysis of the
9 data, yes.
10
11 Q. In paragraph 5.2.2, the last four lines say:
12
13 "The estimated true reduction in coronary risk associated
14 with a 1 per cent reduction in plasma cholesterol
15 concentration, after adjustment for errors in invariables,
16 approaches 3 percent compared to the 2 percent observed in
17 the unadjusted data from epidemiological studies."
18
19 Would you agree with that?
20 A. Well, I could not dispute it. I am sure it must have
21 been carefully worked out.
22
23 MR. JUSTICE BELL: Could you keep your voice up, please,
24 Professor?
25
26 MS. STEEL: Then on the following page, starting on the fourth
27 line, it says:
28
29 "In fourteen trials of under 4 years duration a 10 percent
30 reduction in plasma cholesterol led to a 10 percent
31 reduction in risk compared with a 20 per cent reduction in
32 the 8 trials of more prominent intervention. An analysis
33 of 28 trials by Law et al showed that the full effect of
34 the reduction in risk was achieved by 5 years when the
35 achieved reduction is similar to that observed in
36 prospective studies."
37
38 Would you agree with that?
39 A. Yes, I cannot dispute that.
40
41 Q. If you then turn over to page 113, under the "blood
42 pressure" section, which is 5.3.2. At 5.3.1:
43
44 Systolic and diastolic blood pressure are directly related
45 to the risk of coronary heart disease and stroke."
46
47 It goes on but I will not read it all out but if you read
48 it to yourself.
49
50 MR. JUSTICE BELL: Can you keep your voice up, please, Miss
51 Steel. No doubt it is my hearing, but I find it less of an
52 effort to hear everything if it is loud and clear. Anyway,
53 you want to read 5.3.1?
54
55 MS. STEEL: "An overview analysis of 9 prospective studies,
56 which together followed about 420,000, adults (96 percent
57 men) for an average of 10 years showed the relation between
58 CHD stroke incident and diastolic blood pressure to be
59 linear positive and continuous across the range of
60 pressures studied. When adjustments were made for the
