Can we reduce the number of people that die before age 50? Sir Richard Peto, an expert in vascular diseases at Oxford University, who visited U of T this past Friday, certainly thinks so. Dr. Peto explains that “we have all sorts of things now we didn’t have ‘then'” that should allow us to make sure we get to middle age. He presented evidence showing that blood pressure, cholesterol, obesity, and smoking are leading causes of vascular disease. Preto explained that half of all deaths in the world involve stroke, heart disease and other vascular diseases, and reducing this depends on “prevention and treatment.”
He discussed the differences between “good” and “bad” particles that contain cholesterol. He says it is not enough to just measure body cholesterol levels; we should know about both the good and bad particles carrying this compound. It is possible to determine who can actually get heart attacks based on measurements of the bad particles versus the good particles.
Moreover, lowering blood pressure would “mean a third fewer vascular deaths.” We still do not have perfect blood pressure-lowering drugs. However, if everybody were to use Asprin to lower blood pressure and other drugs to lower cholesterol this would bring down the reccurance of stroke or heart attack to two per cent a year; thus it is possible to “postpone death quite a lot.”
A daily usage of three or four generic drugs could reduce the risk of having a heart attack or stroke by two-thirds, he said. Peto explains that we could combine these drugs to work effectively, on a global scale, without much expense.
Peto said that obesity is going up. As a result, “blood pressure will go up, good cholosterol goes down and bad cholesterol goes up,” and it is likely that diabetes will also increase.
The key to reducing middle aged mortality lies in treating “those who have the disease.” He is not suggesting that everyone go on medication-just those who require treatment. Peto proposes that we must not spend time worrying about little risks, but instead concentrate on the big risks, such as tobacco. He notes that, aside from the risks of lung cancer and emphysema, 80 per cent of smokers have heart attacks during middle age.
He concluded that it is very important for people to know that they need to stop smoking, and that the “risk is big; one quarter of smokers are killed in middle age,” he continued, and “stopping smoking works” no matter at what age a smoker quits. Peto notes that “stopping smoking at even age sixty gains you three years,” and that this “is extraordinary.”
He notes finally that “overall things are getting better,” but we need to “concentrate on big things” and he is “confident in halving middle aged mortality” from current rates.
