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
