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Biomedical subjects

Hannu Vanhanen

Publications and source records attributed to Hannu Vanhanen.

12 recordsLinked to original sources
PubMed2006

Effects of celiprolol and simvastatin on the calculated risk of coronary heart disease (the Celisimva study).

OBJECTIVES: The most important risk factors for coronary heart disease are hypercholesterolemia, smoking and hypertension. To find out which treatment is more effective in modifying the total risk--lowering cholesterol concentration or using antihypertensive treatment--we conducted a parallel group placebo-controlled study. The goal of the study was to assess the effect of two drugs on the calculated CHD Framingham risk score in subjects with both moderate hypertension and moderate hypercholesterolemia. DESIGN: Celiprolol for hypertension and simvastatin for cholesterol-lowering were given as monotherapy or as combination treatment. The effects of the treatments on the CHD risk scores were calculated after 3 months. A total of 112 patients were randomized. RESULTS: The total CHD risk decreased in simvastatin and combination groups from 26% to 19% and from 26% to 17%, respectively. Celiprolol alone decreased the risk from 25% to 21%, which was not statistically different from placebo. CONCLUSIONS: It can be concluded that subjects with moderate hypercholesterolemia and hypertension benefit more from lipid-lowering treatment with simvastatin than from blood pressure-lowering with beta blocker celiprolol.

Aged↗
PubMed2004

Effect of 12-month statin therapy on antioxidant potential of LDL and serum antioxidant vitamin concentrations.

BACKGROUND: Statins are known to cause short-term reduction in serum lipid-soluble antioxidant concentrations, but their long-term effects are not known. AIM: We randomised 104 subjects with CHD and hypercholesterolaemia to receive either atorvastatin or simvastatin treatment for 52 weeks and measured the antioxidant potential of LDL and serum antioxidant vitamin concentrations. METHOD: Initial daily dose for both statins was 20 mg. RESULTS: LDL antioxidant capacity and serum alpha-tocopherol, gamma-tocopherol and beta-carotene concentrations decreased by 22%-35% with both statins during the first 12 weeks' therapy (P < 0.01 for all). After 52 weeks' therapy, the concentrations of serum gamma-tocopherol in the simvastatin group and serum beta-carotene in both treatment groups returned to baseline levels, while the concentrations of serum gamma-tocopherol in the atorvastatin group and LDL anti-oxidant capacity and serum alpha-tocopherol in both treatment groups remained reduced (P < 0.001 for all). The LDL antioxidant capacity:LDL-cholesterol and the serum alpha-tocopherol:LDL-cholesterol ratios were significantly elevated with both statins after 12 and 52 weeks (P < 0.001 for all). Statistically significant increases were also observed for corresponding ratios of the less abundant vitamins gamma-tocopherol and beta-carotene. CONCLUSIONS: Some of the decreases in serum lipid soluble antioxidant vitamins reported in short-term statin interventions may become attenuated when therapy continues longer. The relative antioxidant capacity of LDL particles increased during the 52-week treatment, suggesting that the oxidation resistance of LDL particles did not become impaired and that their atherogenicity did not increase.

Atorvastatin↗
PubMed2002

The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study.

BACKGROUND: After the double-blind, placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial ended in February 1997, randomized patients were offered active study medication for a further period of observation. OBJECTIVE: To refine the estimates of the long-term effects of antihypertensive therapy on the incidence of dementia. METHODS: Eligible patients had no dementia and were at least 60 years old. Their systolic blood pressure at entry was 160 to 219 mm Hg, with diastolic blood pressure below 95 mm Hg. Antihypertensive therapy was started immediately after randomization in the active treatment group, but only after termination of the double-blind trial in the control patients. Treatment consisted of nitrendipine (10-40 mg/d), with the possible addition of enalapril maleate (5-20 mg/d), hydrochlorothiazide (12.5-25 mg/d), or both add-on drugs. RESULTS: Median follow-up increased from 2.0 years in the double-blind trial to 3.9 years overall. The incidence of dementia doubled from 32 to 64 cases, 41 of whom had Alzheimer disease. Throughout follow-up, systolic/diastolic blood pressure was 7.0/3.2 mm Hg higher in the 1417 control patients than in the 1485 subjects randomized to active treatment. At the last examination, the blood pressure difference was still 4.2/2.9 mm Hg; 48.1%, 26.4%, and 11.4% of the control patients were taking nitrendipine, enalapril, and/or hydrochlorothiazide, whereas in the active treatment group these proportions were 70.2%, 35.4%, and 18.4%, respectively. Compared with the controls, long-term antihypertensive therapy reduced the risk of dementia by 55%, from 7.4 to 3.3 cases per 1000 patient-years (43 vs 21 cases, P<.001). After adjustment for sex, age, education, and entry blood pressure, the relative hazard rate associated with the use of nitrendipine was 0.38 (95% confidence interval, 0.23-0.64; P<.001). Treatment of 1000 patients for 5 years can prevent 20 cases of dementia (95% confidence interval, 7-33). CONCLUSION: The extended follow-up of Syst-Eur patients reinforces the evidence that blood pressure-lowering therapy initiated with a long-acting dihydropyridine protects against dementia in older patients with systolic hypertension.

Aged↗
PubMed2002

[ASA therapy or not?].

Explore the source record for details and available documents.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2001

The problem-based learning tutorial laboratory - a method for training medical teachers.

An extensive staff development program was started in 1998 in the Faculty of Medicine at the University of Helsinki. A problem-based learning method was introduced as a new style of teaching in the curriculum reform. This paper describes a teaching method 'Problem-based learning - tutorial laboratory' for training medical teachers to act as tutors and to understand their roles as facilitators of learning and the dynamics of a small group. The method was based on learning cycles: teachers had a possibility to experience tutoring, to get feedback about it from an educational expert and from a peer teacher and also they were able to reflect on their views in the group. The teachers were content with the training. Sessions improved teacher cooperation across the departments and brought new teaching ideas for shared use. It also helped to cope with the resistance related to the curriculum change process.

Journal Article↗
PubMedDate not supplied

Family support, living alone, and subjective health of a patient in connection with a coronary artery bypass surgery.

OBJECTIVE: The study's objective was to evaluate the connections among family support, living alone, and subjective health after coronary artery bypass surgery (CABS). DESIGN: This was a prospective and comparative follow-up study. SETTING: The study took place in surgical clinics in two university hospitals in Finland. PATIENTS: A total of 279 patients underwent CABS. The sample comprised consecutive patients who were willing to participate. INTERVENTION: The patients were asked to evaluate their subjective health before surgery (initial phase) and 6 months after surgery (follow-up phase). OUTCOME MEASURES: Outcome was measured by the Chest Pain and Dyspnea Scale, Modified Beck Depression Inventory, Endler Anxiety Scale, Family Support Scale, and Hopelessness items. RESULTS: Subjective health improved significantly after CABS. Those who had lower family support before surgery had more depressive symptoms, anxiety, and hopelessness than those who had more support. In the group with low family support, the subjective health of women was poorer than that of men, and those who had no vocational education described poorer health than others. In the group with high family support, those who had no vocational education had more chest pain and dyspnea than others. Patients who were living alone had initially more depressive symptoms and hopelessness compared with patients living with someone. At follow-up, those living alone reported more chest pain and depressive symptoms than those living with someone. Patients aged less than 65 years and living alone reported more depressive symptoms, anxiety, and hopelessness than the oldest age group during the follow-up. In those patients living with someone, the subjective health of female patients, patients aged less than 65 years, and patients who had no vocational education was poorer than others. CONCLUSIONS: High family support seemed to protect health and promote recovery. In nursing it is important to take care of those who receive only limited amount of family support or who live alone. These results suggest that women, patients aged less than 65 years, and patients with no vocational education may need additional support and care.

Activities of Daily Living↗
PubMedDate not supplied

Self-rated health and risk factors for metabolic syndrome among middle-aged men.

OBJECTIVES: To examine lifestyle and clinical risk factors for metabolic syndrome (MBO) and compare their significance between levels of self-rated health among middle-aged men. DESIGN: A cross-sectional baseline study. SAMPLE: 273 men, aged 40, living in Helsinki, Finland. METHODS: Postal questionnaires and health examinations by public health nurses were used in data collection. Statistical differences between groups of self-rated health and risk factors were analyzed by chi-square tests. RESULTS: Of all the respondents, 55% rated their health as good and 45% as average. Two thirds were overweight or obese, and 35% had waist-hip ratio more than 100 cm. Approximately 43% had diastolic blood pressure greater than 90 mmHg. Over half of the men smoked daily, and 28% used alcohol excessively. CONCLUSIONS: The men in this sample were found to be at high risk of developing MBO. The results underscore the importance of understanding the contradiction that exists between subjective and objective health ratings. Public health nurses are in a key position to educate men on how to use simple measurements to objectively assess their risk factors and, thus, potentially reduce their risk of developing diabetes, heart attack, or stroke.

Cross-Sectional Studies↗