Nine out of ten run risk of heart disease or strokes: Health survey finds few willing to change their diet or take more exercise

ALMOST 90 per cent of adults in England have one or more of the four main risk factors for heart disease and stroke, according to the first government survey of the nation's health.

The survey found that only 12 per cent of men and 11 per cent of women had none of the risk factors - high blood pressure, raised cholesterol, smoking and lack of physical activity. One in five people scored badly on three out of four; 2 per cent of men and 3 per cent of women scored on all four.

The survey of almost 3,000 men and women, aged 16 to 64, reveals the grimmest picture yet of an overweight population, reluctant to make any dramatic change in eating and drinking habits, to take more exercise and struggling to give up smoking.

A quarter of those who took part had already suffered from at least one illness, such as angina, diabetes or high blood pressure, linked with cardiovascular disease. More than two-thirds of the sample had blood cholesterol above the desired level and the number of obese men had almost doubled in seven years.

Despite the findings, three- quarters of people in the study believed their general health to be 'good' or 'very good'. But the results have prompted Dr Kenneth Calman, the chief medical officer, to challenge every person in the country to adopt one or more of a list of 20 lifestyle changes. 'It is obviously a cause for concern that so few people are completely risk free from coronary heart disease,' he told a press conference in London yesterday.

Dr Calman gave his strongest indication yet that he favours banning tobacco advertising. He is at odds with Virginia Bottomley, the Secretary of State for Health, who has steadfastly opposed a ban. The Government's annual revenue from tobacco is pounds 6.6bn. Dr Calman said he did not make his advice to ministers public, but said he was a member of the medical profession which has consistently called for a ban.

David Blunkett, Labour's health spokesman, said that Mrs Bottomley's position could no longer be sustained.

The survey, the first of a series, was carried out by the Office of Population Censuses and Surveys among a representative sample of the population between September and December 1991. The aim was to provide baseline data relevant to coronary heart disease, stroke and nutrition as part of the Government's Health of the Nation project, which aims to cut heart disease and strokes in the under- 65s by 40 per cent by 2000.

Other findings show that the number of adults classed as obese has increased from 7 to 13 per cent among men, and from 12 to 15 per cent among women since 1986-87. Only one- fifth of the men and 12 per cent of the women had exercised 'vigorously' at least three times a week in the survey period. A quarter of men and just under one-third of women who smoked said that they had tried to stop because of their health.

Dr Lindsey Davis, who chairs the British Medical Asscoiation committee for public health, said the Government's failure to ban tobacco advertising meant the survey 'may serve only as an indicator of failure rather than a manifesto for the future for the nation's health'.

Health Survey for England 1991; HMSO; pounds 27.50.

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