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teacher becomes aware that a child is addicted, effective action
is likely to be involved and prolonged.
Heart Disease
Great play has been made in recent years by mass media on
heart disability and it is perhaps not surprising to find that many
people now regard it as synonymous with "coronary" disease.
Indeed, among society generally, there is now not only a greater
awareness of the damaging effects of a disease which strikes in
such a sudden and unpredictable manner but also an understandable
growing fear on the part of the community of its own
vulnerability.
Undoubtedly, epidemiologically, heart disease is proving to be
modern society's greatest menace for it ranges over the whole
span of life from genotypic conditions, through those acquired
as residual effects of disease to the types concomitant with old
age.
It can be demonstrated that, surgically, a considerable measure
of success is being achieved with some congenital heart conditions
and those precipitated by a previous rheumatic fever episode and,
with the aid of the pharmacist, heart failure arising from stress of
high blood pressure is becoming rarer. Nevertheless, mortality
from coronary artery and ischaemic heart disease continues to
rise and has already reached epidemic proportions in the Western
world. A high mortality rate for ischaemic heart disease is common
in advanced countries and, in international terms, of 14
such countries returning accurate statistics it is highest in
Finland with Scotland taking 3rd place and England and Wales
in 7th position. Moreover, in the upper part of this "league" table
more than ⅓rd of all adult males succumbed to this disease. It
is true that there is some substance in the proposition that, prior
to 1930, examination of coronary arteries at autopsy was
frequently omitted and that the subsequent declared increase in
ischaemic heart disease is therefore suspect. However, recent
experience in these countries points to a real increase, particularly
in the younger age groups and evidence already exists to
show that persons removing from a low to a high prevalence area
acquire, in due course, the higher prevalency rate.
Results of studies already carried out would seem to indicate
that, clinically, coronary artery disease is correlated with such risk
factors as obesity, high serum cholesterol, increased blood pressure,
family history in respect of the disease and cigarette smoking.
Other influences which are difficult to evaluate in this connection
include indolence, stress and hormonal activity and,