Vol. 417 No. 9
226 Mr. Allen asked the Minister for Health if he will make a statement on a recent study published in the British Medical Journal which was conducted in Finland and which showed that middle-aged men treated by doctors for heart complaints were more likely to die than those who ignored coronary problems; and if he will make a statement on the matter.
I am aware of the findings of the recent study published in the British Medical Journal on the outcome of intervention with middle-aged Finnish men who had one or more risk factors for coronary heart disease.
These men were seen regularly and advised about diet, physical activity and smoking and were treated if hypertension or hyperlipidaemia was present. Following the intervention the risk factors for coronary heart disease had reduced by almost half in the intervention group. Despite this, more non-fatal and fatal heart attacks occurred in the intervention group compared to the control group.
The authors of the study could provide no convincing explanation for their findings. The findings need to be put in the context of an extensive range of other studies of interventions worldwide to reduce mortality and morbidity from coronary heart disease, some of which indeed support these findings.
However, the balance of evidence suggests that significant reductions in mortality and morbidity from coronary heart disease can be achieved in countries where healthier lifestyle practices have been adopted. Such practices include avoidance of tobacco consumption, balanced nutrition, moderate alcohol consumption, and regular exercise. These core ingredients in any community based intervention are in line with WHO recommendations and are widely implemented internationally. Indeed there has been a significant drop in deaths from heart disease in both men and women recorded in this country from 1980 to 1988 — the latest years for which detailed figures are available.
It is, of course, more difficult to change one's lifestyle in middle age than to develop healthy lifestyle habits from an early age. A community based approach provides the strongest and most supportive environment for adopting and maintaining healthy lifestyles. The approach to healthy lifestyles involving the entire population — young, middle aged and elderly — is the best recipe for reducing our relatively high rates of death from coronary heart disease.
