Segment 1 Opening titles. Dr Meade introduces the topic of improving the prediction of arterial disease, saying he will address mainly ischaemic heart disease. He says some doctors do not think an improvement in detection is necessary as 'myocardial infarction is a good way to die'. He however, believes this is a plan for inaction and gives two reasons for improvement: better motivation for patients to change their lifestyles and discovery of new information about causes of coronary disease. A graph shows a hypothetical perfect test for the prediction of heart disease, using 100 middle-aged men. Time start: 00:00:00:00 Time end: 00:05:46:20 Length: 00:05:46:20
Segment 2 Meade displays another graph that shows 100 middle-aged men in a real-life situation, tested with the means currently available. More men go on to develop heart disease. Meade discusses the possibility of reducing the time of the test to five years as well as the possibility of measuring multiple risk factors instead of just cholesterol and blood pressure. He suggests measuring cigarette smoking, early ECG changes and obesity. Time start: 00:05:46:20 Time end: 00:09:27:16 Length: 00:03:40:21
Segment 3 Meade continues to discuss factors that lead to heart disease and wonders if there is a more rapid process that can lead to myocardial infarction or sudden death. He considers a thrombus formation. He talks about a hypothetical case study involving four men, all of whom have atheroma but only one develops clinical heart disease. Meade believes that this would be because a thrombus formed, so more study of the thrombotic process is needed. He describes case studies being undertaken in London and summarises the tests the patients are undergoing, including platelet function, clotting factor levels and fibrinolytic activity. The results of the study are seen. Time start: 00:09:27:16 Time end: 00:15:14:00 Length: 00:05:46:09
Segment 4 Meade continues to discuss the case study data, including people who were free of the disease when they were recruited but then developed the disease. He discusses the findings with regard to age, sex, fibrinolytic activity, smoking and blood pressure. Time start: 00:15:14:00 Time end: 00:20:08:00 Length: 00:04:54:00
Segment 5 Meade uses the case study data to examine the relationship between fibrinolytic activity and lipids (cholesterol and triglycerides). The relationships between fibrinolytic activity and obesity and fibrinolytic activity and clotting factors are also looked at. He particularly discusses the factor of taking the contraceptive pill (in women). He mentions another case study of diabetic patients; again, the data is displayed on screen. Time start: 00:20:08:00 Time end: 00:25:05:00 Length: 00:04:57:00
Segment 6 Meade discusses how his case study analysed data from white British and West Indian immigrants, and he compares the results. He also shows the values from ten men who already had a definite myocardial infarction before the study began. He ends the lecture by summarising his case study findings. Time start: 00:25:05:00 Time end: 00:30:48:17 Length: 00:05:43:17