Sucrose and cardiovascular disease.

Like other speakers today, I propose to confine myself to one manifestation of cardiovascular disease, namely ischaemic heart disease (IHD). It is unlikely that there is any single statement one could make about cardio.irascular disease in gcneral, or about IHD in particular, that would command universaI agreement. The natural history of atherosclerosis, the relationship between atherosclerosis and IHD, the relative prevalence of I H D in different countries, whether there has been a real increase in its prevalence in affluent countries over the past century and if so the size of this increase: these are only a few of the questions about which debate continues. I believe however that there would be widespread if not universal agreement about the following three statements. First, there are several environmental factors that may produce I H D ; among those that have been suggested are cigarette smoking, physical inactivity, stress, and diet. Second, persons suffering from IHD show a wide range of abnormalities, of which one is the common though not universal high level of plasma cholesterol. Third, IHD is associated in varying degree with other diseases such as diabetes, peripheral vascular disease, and peptic ulceration. With these points in mind, let me then summarize the evidence that dietary sucrose is a factor in the aetiology of IHD.