Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 181 records · Page 10Linked to original sources

PubMed1987

Body weight and risk of myocardial infarction and death in the adult population of eastern Finland.

Body mass index (weight (kg) divided by height squared (m2] and its association with the risk of myocardial infarction and death from all causes were studied prospectively in a randomly selected population sample in eastern Finland aged 30-59 at outset in 1972. The study population consisted of 3786 men and 4120 women. The participation rate in the survey in 1972 was over 90%. All deaths and admissions to hospital in the sample were obtained from the National Death Certificate and Hospital Discharge Registers. During the seven years of follow up until 1978, 170 men and 52 women had acute myocardial infarction, and during the nine years up to 1980, 223 men and 92 women died. Independent of age, men with a body mass index of 28.5 or more had a significantly higher incidence of acute myocardial infarction. This effect was also independent of smoking but not independent of biological coronary risk factors--that is, serum cholesterol concentration and blood pressure. In the analysis stratified for smoking in men the body mass index total mortality curve was J shaped among non-smokers, whereas smoking entirely outweighed body mass index as a predictor of death. Body mass index did not contribute significantly to the risk of either acute myocardial infarction or death in women. It is concluded that a body mass index of around 29.0-31.0 or more is not only a marker for coronary risk factors but is also a predictor of acute myocardial infarction in men.

Adult↗

PubMed1987

Metabolic epidemiology of colon cancer: effect of dietary fiber on fecal mutagens and bile acids in healthy subjects.

Because of potential significance of fecal mutagens and secondary bile acids in the pathogenesis of colonic cancer and of inverse association between dietary fiber and colonic cancer risk, the effect of dietary wheat and rye fiber on fecal mutagenic activity and bile acid levels was studied in 15 healthy men and women who were consuming high fat/moderately low fiber diets and excreting high levels of fecal mutagens and bile acids. Each participant provided two 24-h stool specimens and a 3-day diet record while consuming their normal diet (control). All subjects were then asked to consume their normal diet plus 11 g of supplemental fiber per day in the form of whole grain bread for 4 weeks. During the last week of diet intervention, each subject provided two 24-h stool specimens and a 3-day dietary record. Fecal samples collected from both periods were analyzed for bile acids and for mutagens using Salmonella typhimurium strains TA98 and TA100 with and without microsomal activation. The concentration of fecal secondary bile acids was significantly lower during the fiber supplemental period in all subjects. Fiber supplementation also inhibited the fecal mutagenic activity in TA100 and TA98 with and without microsomal activation. Thus, the increased fiber intake in the form of whole wheat and rye bread may reduce the production and/or excretion of fecal mutagens and decrease the concentration of fecal secondary bile acids in humans.

Bile Acids and Salts↗

PubMed1987

Age and regional differences in reliability and factor structure of the Zung Self-rating Scale in elderly Finnish men.

Regional and age differences in the reliability and factor structure of the SDS among elderly (65-84 years) men who were living either in eastern or in southwestern Finland were investigated. The Cronbach alpha coefficient was .803 for the eastern and .809 for the southwestern cohort; these figures were reasonably high. The tendency found was for the coefficient to be somewhat higher for the old (75-84 years) than for the young-old (65-74 years) population. In investigating the factor structure, a principal components factor analysis was performed, and the remaining factors were rotated using the orthogonal Varimax rotation algorithm. Three factors emerged for young-old men in the East, for young-old men in the Southwest and for old men in the Southwest, and four factors for old men in the East. The factor patterns of the first two factors showed similarities in both regions, but their order was different. "Loss of self-esteem" accounted for more of the common variance in the East and "agitated mood" in the Southwest. The differences in the third factor between the two regions were evident.

Aged↗

PubMed1987

Interdependence of associations of physical activity, smoking, and alcohol and coffee consumption with serum high-density lipoprotein and non-high-density lipoprotein cholesterol--a population study in eastern Finland.

The interdependence of the associations of physical activity, smoking, and consumption of alcohol and coffee with serum high-density lipoprotein and non-high-density lipoprotein cholesterol concentrations was studied in 9,347 persons ages 25-64 years from east and southwest Finland. In covariance analyses with corrections for age, body mass index, saturated fat index, and fasting time, the mean adjusted serum high-density lipoprotein to non-high-density lipoprotein cholesterol ratio was high among physically active male non-smokers but not among smokers (P = 0.024 for two-way interaction). The cholesterol ratio was lower among both men (P = 0.010 for two-way interaction) and women (P = 0.030 for two-way interaction) reporting no or very little use of alcohol, and this association was stronger among smokers and women with high coffee consumption (P less than 0.001 for two-way interaction). Our data suggest that the elevating effect of regular physical exercise on serum high-density lipoprotein cholesterol may be absent in smokers, whereas that of alcohol is greater in smokers than nonsmokers. High coffee consumption associates with decreased serum high-density lipoprotein cholesterol levels in smokers but increased levels in non-smokers.

Adult↗

PubMed1987

The changing role and legitimate boundaries of epidemiology: community-based prevention programmes.

Epidemiology is the basic science of public health. It combines medical and social sciences, both of which are developing with new inventions. Therefore, the role of epidemiology and its boundaries are also changing over time. An important role of epidemiology is to develop and implement community-based control programmes for major diseases in the community. Such programmes are essential for large scale public health policy. It is necessary that epidemiological research can as freely as possible test new methods of disease prevention and health promotion. The first community-based control programme for cardiovascular diseases, the North Karelia Project is reviewed against this background. At present, it is still possible to define the boundaries of epidemiology geographically and culturally, but in the future, however, it will become more difficult. There is no doubt that epidemiology will remain as the basic science of public health but the scope of public health problems are growing much wider. These include the prevention of the final epidemic--the destruction of our planet by nuclear bombs. In the control of the existing epidemics and in the prevention of new ones the boundaries of epidemiology cannot stay rigid but they must be changing as new facts about the emerging public health problems are identified.

Cardiovascular Diseases↗

PubMed1987

Leisure-time physical activity is inversely related to risk factors for coronary heart disease in middle-aged Finnish men.

Coronary risk factors and levels of physical activity at leisure were measured in a random sample of 3975 men 25-64 years of age residing in four areas of Finland. An index of leisure-time physical activity (LTPA) as the product of weekly exercise sessions times their usual intensity (expressed as metabolic equivalents) was computed. It showed a graded, inverse association with mean arterial blood pressure, smoking and serum thiocyanate, coronary heart disease risk estimate (combining blood pressure, total cholesterol and smoking), and a nonlinear favorable association with serum lipoproteins. In multiple regression analysis, LTPA contributed significantly and independently to the variation in mean arterial pressure; the standardized regression coefficients were -0.06 for LTPA, 0.09 for weekly alcohol consumption, 0.25 for body mass index, 0.25 for age. In the regression of coronary risk estimate, the standardized regression coefficients were -0.19 for LTPA, 0.22 for weekly alcohol consumption, 0.09 for body mass index, 0.15 for age. There was no evidence that LTPA above 2000 kcal of weekly energy expenditure was associated with further reduced coronary risk factor levels. These findings thus support the inverse direction of the association between exercise and coronary risk factors but they also point towards an independent, but modest, role of leisure-time physical activity as a determinant of coronary risk estimate and blood pressure.

Adult↗

PubMed1987

Relationship between leisure-time physical activity and risk factors for coronary heart disease in middle-aged Finnish women.

Risk factors for coronary heart disease (CHD) and levels of leisure-time physical activity (LTPA) were measured in a random sample of 4,059 women aged 25-64 years, residing in four areas of Finland. LTPA indexed as the product of weekly exercise sessions X their usual intensity showed an inverse association with smoking (p = 0.02) and with CHD risk estimate which combines the three main risk factors, smoking, serum cholesterol and blood pressure (p = 0.06), and a positive association with HDL cholesterol (p = 0.002). It was not associated with mean arterial pressure and serum total cholesterol. In a multiple regression analysis LTPA contributed independently, though modestly, to the model for CHD risk estimate. Age and body mass index were the most important independent predictors of both mean arterial pressure and CHD risk estimate. It is concluded that in middle-aged Finnish women, unlike men of the same population, high LTPA is only weakly related to lower CHD risk factor levels.

Adult↗

PubMed1987

Comparison of the levels of cardiovascular risk factors between eastern and south-western Finland in 1982.

Altogether 6,523 persons aged 25-64 years were studied in eastern and south-western Finland to determine their cardiovascular risk factor levels. Among men, smoking was more prevalent in the south-western area (41 vs. 37%), serum cholesterol levels were higher in the eastern area (6.2 vs. 6.0 mmol/l) and blood pressure levels were the same in both areas (145/86 in the east vs. 144/86 in the south-west). Among women, smoking was also more common in the south-western area (24 vs. 16%) and serum cholesterol levels were higher in the eastern area (6.1 vs. 6.0 mmol/l) as well as blood pressure levels (142/84 vs. 138/81 mmHg). Among both genders, prevalence of hypertension and proportion of persons on antihypertensive drug therapy was higher in eastern Finland. The comparison of these findings with the results from previous studies carried out among men in these two areas indicates that the risk factor levels have been decreasing in both areas and that the previously observed differences in risk factor levels between eastern and south-western Finland (the levels used to be higher in the east) have levelled off. The favourable development in eastern Finland may be a result of the North Karelia Project.

Adult↗

PubMed1987

Serum total cholesterol, HDL cholesterol and blood pressure levels in 15-year-old adolescents in eastern Finland.

Serum total cholesterol, HDL-cholesterol and blood pressure were studied among 15-year-old school children in Eastern Finland. The mean serum total cholesterol was 4.47 mmol/l in boys and 4.86 mmol/l in girls; mean HDL-cholesterol was 1.29 mmol/l and 1.46 mmol/l, respectively. The mean blood pressure was 135/65 mmHg in boys and 126/67 mmHg in girls. Obese children had higher blood pressure and lower HDL-cholesterol levels than others. Among boys sexual maturation decreased the HDL-cholesterol level. Children whose parents had histories of cardiovascular disease did not have higher cholesterol or higher blood pressure levels than other children. Children at high risk apparently cannot be screened on the basis of parents' history of cardiovascular diseases.

Adolescent↗

PubMed1987

Relationship of plasma level of vitamin C to mortality from ischemic heart disease.

The present epidemiological data support and extend previous evidence in men and animals. Thus, a poor plasma status of vitamin C (less than 23 microM = 0.4 mg/dl) and/or of cholesterol-standardized vitamin E (less than 20-21.5 microM = 9 mg/l) occurs in westernized countries with an increased risk of IHD. A poor status in the major essential antioxidants may be a hitherto underrated, at least permissive, risk factor of IHD that could, at least in some European countries, substantially complement the previously established risk factors such as hypercholesterolemia.

Adult↗

PubMed1987

Coffee consumption is correlated with serum cholesterol in middle-aged Finnish men and women.

The association between coffee consumption and serum cholesterol was studied in a cross-sectional epidemiological study in Finland where the annual per capita consumption of coffee (13.0 kg) is the highest in the world. Coffee consumption was assessed by a questionnaire in a representative population sample of 4744 men and 4495 women aged 25 to 64 years. Serum total cholesterol and HDL-cholesterol concentrations were determined in fresh sera by the enzymatic method. Data on a large number of potential confounding variables were also collected. In the age group 25 to 44 years, the level of serum total cholesterol increased linearly with increasing coffee consumption in both sexes, but in people aged 45 to 64 the peak level of serum cholesterol was found in those who consumed 4 to 6 cups of coffee per day. In the analysis of covariance controlling for age, body mass index, intake of fat, sugar, and alcohol, smoking, physical activity, and fasting time, the mean level of serum cholesterol of men was lower (p less than 0.001) in those who drank no coffee (5.9 mmol/l) than in those who drank 1 to 3 cups (6.1 mmol/l) or 4 or more cups (6.2 mmol/l) per day. In women, the corresponding mean serum cholesterol values were 5.8 mmol/l, 6.1 mmol/l, and 6.1 mmol/l (p less than 0.05). Serum HDL-cholesterol levels did not vary significantly with coffee consumption. There was a slight inverse association between tea drinking and serum total cholesterol in men (p less than 0.05) but not in women. Although our results suggest a positive association, the impact of coffee drinking on serum cholesterol seems to be minimal. The results also indicate that the possible mechanisms do not include caffeine.

Adult↗

PubMed1987

Accuracy of self-reported body weight compared to measured body weight. A population survey.

In 1977, in the evaluation of the prevention programme for cardiovascular diseases, 11,880 persons in Eastern Finland were asked to report their own weight on a questionnaire. Each participant was weighted during the following clinical examination. The data of the self-reported body weight were analysed according to sex, age, measured weight and body-mass index (BMI). The results showed that older people underestimated their weight to a greater extent than did younger people of both sexes. The error between measured and self-reported weight was greater in heavier subjects than in thinner individuals. In both sexes weight estimate error (measured weight minus self-reported weight) correlated more strongly with high BMI than with measured weight. Associations between weight estimate error and other variables were studied using a multiple regression model. Men whose annual family income was low were more likely to underestimate their weight than the men with a high annual income. In general, women reported their weight more correctly than men did. Older women were more likely to report their weight less than younger women, whereas women who visited their doctor frequently or who had higher annual family incomes were more aware of their actual body weight than those who had few doctor's consultations or whose family income was low. In men 5.2% and in women 8.3% of the variation in the weight estimate error was explained by the regression model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1987

Predictors of blood pressure change in a series of controlled dietary intervention studies.

Three controlled dietary intervention studies were carried out in 1981-1983 in North Karelia, Finland, to asses the impact of dietary fat intake modification on blood pressure (BP). All these studies involved middle-aged men and women in rural or semirural areas and comprised a baseline period, a six week (or 12 weeks in the third study) intervention period and a four to six week return to baseline. During the intervention period the total fat intake was reduced from 39% to 24% of energy and the polyunsaturated/saturated (P/S) ratio increased from 0.2 to 0.4-1.2. In all groups energy intake was kept constant. For the present report data from the three studies were pooled for a series of stepwise regression analyses to predict changes in BP with different dietary changes. For both systolic (SBP) and diastolic (DBP) blood pressure, change in polyunsaturated fatty acid intake was the strongest dietary predictor of BP change. Changes in body weight, total fat intake, urinary sodium and potassium did not have significant predictive power in any of the analyses. The findings support the hypothesis that modification of dietary fat intake is a significant predictor of change in BP.

Blood Pressure↗

PubMed1987

Trends in stroke mortality and in antihypertensive treatment in Finland from 1972 to 1984 with special reference to North Karelia.

Trends in antihypertensive treatment and stroke mortality were analysed in the province of North Karelia where the first systematic hypertension control programme in Finland was started in 1972. Surveys carried out in random samples of the middle-aged population of North Karelia showed that the control of hypertension was better than in the reference area, especially from 1972 to 1977. From 1972 to 1984, mortality from stroke fell on average 6.3% and 7.6% per annum, in North Karelian men and women aged 35-64 years. These declines were steeper than those observed in the rest of Finland. In the age group of 65-74 years the decline in stroke mortality was also steeper in North Karelia. From 1978 to 1984 the self-reported awareness of hypertension and the proportion of people receiving antihypertensive drug treatment decreased in the middle-aged population in Finland, suggesting lesser efforts at detection and treatment. During the same period, the steep national decline in stroke mortality levelled off, but the mortality rate remained higher than in the USA and in other Western European countries. Prevention of stroke through hypertension control in the community still remains a major challenge for health care.

Adult↗

PubMed1986

Decline in cardiovascular mortality in North Karelia and other parts of Finland.

The trends in mortality from ischaemic heart disease, cerebrovascular stroke, and all cardiovascular diseases were analysed for the province of North Karelia and for the rest of Finland. Linear trends in mortality were computed for the population aged 35 to 64 for the period from 1969 to 1982, and changes in mortality between the three year means of 1969-71 and 1980-2 were calculated. In North Karelia, where a community based preventive programme has been carried out since 1972, the annual decline in mortality from ischaemic heart disease in men was on average 2.9%, whereas in the rest of Finland it was 2.0%. For women the respective average annual declines in mortality were 4.9% and 3.0%. The net decline from 1969-71 to 1980-2 in North Karelia was 100 deaths/100,000 men. The annual mortality from all cardiovascular disease in men decreased by 2.9% in North Karelia and by 2.6% in the rest of Finland; in women the decreases were 6.0% and 5.0% a year, respectively. The net decline in North Karelia was 71 deaths/100,000 men. The decline in mortality from all causes was also appreciable in both sexes in North Karelia, but it did not differ significantly from national trends.

Adult↗

PubMed1986

Linoleic acid content in adipose tissue and coronary heart disease.

The possibility of an inverse relation between essential fatty acids in adipose tissue, in particular linoleic acid, and mortality from coronary heart disease was studied by a cross sectional survey of random population samples of apparently healthy men aged 40-49 from four European regions with differing mortality from coronary heart disease. The proportion of linoleic acid in adipose tissue was lowest in men from north Karelia, Finland, where mortality from coronary heart disease is highest, and highest in men from Italy, where mortality is lowest, with intermediate proportions in men from Scotland and south west Finland. Similar gradients were observed for the desaturation and elongation products dihomo-gamma-linolenic and arachidonic acid. The proportion of saturated fatty acids in adipose tissue was highest in Finland, intermediate in Scotland, and lowest in Italy. Italian men also had the highest proportion of oleate in their adipose tissue and the lowest proportion of myristoleate and palmitoleate. Finnish men were more obese and had a higher blood pressure. Serum cholesterol concentration was higher in north Karelia and south west Finland than in Scotland or Italy. High density lipoprotein (HDL) cholesterol concentrations reflected the regional differences in serum cholesterol, being higher in Finland and lower in Italy. The ratios of HDL cholesterol to total cholesterol, however, did not differ. The regional differences in linoleic acid in adipose tissue remained highly significant when the observed differences in other known risk factors for coronary heart disease among the four areas were taken into account by multivariate analysis. The gradients in proportions of polyunsaturated fatty acids probably reflect differences in dietary intake of linoleic acid.

Adipose Tissue↗

PubMed1986

Relationships of serum lipoproteins and apoproteins to sex hormones and to the binding capacity of sex hormone binding globulin in healthy Finnish men.

We have determined the levels of serum sex hormones, the binding capacity of sex hormone binding globulin (SHBG), urinary estrogens, serum lipids, lipoproteins, and apolipoproteins A-I, A-II, and B in 30 healthy middle-aged Finnish men with similar dietary habits. Serum levels of total testosterone, free testosterone, 5 alpha-dihydrotestosterone (5 alpha-DHT), and the binding capacity of SHBG were all positively correlated to high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apo A-I) (r = .43 to .80, P less than 0.05 to 0.001). Total testosterone and 5 alpha-DHT showed a positive correlation to the ratio of apo A-I to Apo A-II (r = .37, P less than 0.05 and r = .58, P less than 0.01, respectively). Serum estradiol levels were negatively correlated to serum total cholesterol, low density lipoprotein cholesterol (LDL), and Apo B (r = -.51 to -.56, P less than 0.01). Moreover, serum free estradiol was negatively correlated to HDL-C and Apo A-I (r = -.46 and r = -.50, P less than 0.01). In multiple linear regression analysis, 5 alpha-DHT was the most significant independent determinant of HDL-C and apo A-I levels when androgens, luteinizing hormone, estradiol, binding capacity of SHBG, and exogenous factors such as age, body mass index (BMI), smoking, alcohol consumption, and diet were taken into account. Multivariate analysis also demonstrated that both total and free estradiol were inversely related to serum Apo B levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Four-year follow-up results of the smoking prevention program in the North Karelia Youth Project.

The North Karelia Youth Project was a 2-year intervention study aimed at preventing cardiovascular diseases risk factors among 13-year-old adolescents at the project's start. It was carried out during the years 1978 to 1980 in the county of North Karelia, Finland. The smoking prevention portion of the program was aimed at teaching children skills necessary to handle the social and psychological pressures associated with starting to smoke. During the 2-year program, 10 sessions were carried out in two schools by the project team and by specially trained peer leaders. In about half of the remaining 22 schools in North Karelia, a five-session program was carried out voluntarily by the teachers. After the program, 20% of the children in the two schools where the direct intervention was carried out reported smoking at least once a month. The same rate also was observed in two matched schools representative of the rest of the schools in North Karelia. In two other matched control schools in another county, 30% of the pupils reported to be smokers by the same criteria. Two years after the program (4 years after the beginning of the program), the reported smoking rates in the different school groups were 27, 26, and 37%, respectively. The results of this pilot study indicate that it is possible to reduce smoking onset by this kind of innovative program and that the beneficial effect can last several years.

Adolescent↗