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Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 199 records · Page 11Linked to original sources
PubMed1986

Long-term effects of cessation of smoking on body weight, blood pressure and serum cholesterol in the middle-aged population with high blood pressure.

Smoking habits are continuously changing in the population. Cessation of smoking is not only often difficult but may lead to undesired consequences, esp. to weight gain. A random sample of 2283 persons with mild hypertension was followed up for 5 years in Eastern Finland and examined at the community-based cardiovascular program. During that time 30% of those smoking initially stopped smoking. Men gained weight on the average 3.6 kg upon stopping smoking (p less than 0.001) after controlling for age, change in fat and sugar intake and change in physical activity at leisure time). In women cessation of smoking was not related to weight changes. There was no evidence in this follow-up that smoking or cessation of smoking would have any independent impact on blood pressure or serum total cholesterol level.

Adult↗
PubMed1986

Cost-effectiveness of the North Karelia Hypertension Program. 1972-1977.

The North Karelia Hypertension Program was initiated in 1972 as part of the North Karelia Project. This article examines the costs and effects of the first 5 years of the project. There were 288 fewer than expected fatal strokes and myocardial infarctions during the period; 134 of these are attributable to the hypertension program. The costs of the hypertension program totalled $5.16 million. Drugs consumed 86% of this cost. Using the zero discount rate as an outside boundary, the program is expected to increase old age pension costs by $2.5 million for the 5 years but will decrease earnings losses by $7 million for the same period. With earnings excluded, the cost per quality-adjusted life-year gained is $3,612 at zero discount and $5,830 at 10% discount. Hypertension care is more cost-effective than many of the treatments applied after the appearance of coronary heart disease symptoms but would be much more cost-effective if hypertension could be treated as effectively without medications or if the costs of medications could be reduced.

Adult↗
PubMed1986

Thyroid function tests in elderly Finnish men.

Serum total thyroxine (T4), triiodothyronine (T3) and thyrotrophin (TSH) levels were determined among 65-84-year-old Finnish men living either in eastern Finland (n = 309) or in southwestern Finland (n = 389). The mean value for serum total T4 was 112.2 +/- 23.0 nmol/l in eastern Finland and 111.3 +/- 21.9 nmol/l in southwestern Finland. The mean value for serum T3 was 1.76 +/- 0.30 nmol/l in eastern Finland and 1.75 +/- 0.46 nmol/l in southwestern Finland. Serum TSH values showed the mean for men from eastern Finland to be 3.25 +/- 2.29 mU/l and the mean for men from southwestern Finland to be 3.11 +/- 1.83 mU/l. No differences were found in the means of the thyroid function tests between the two areas. Serum T4 levels were not related to age. Serum T3 values fell with age. In both areas, serum TSH levels were highest among men 70-74 years of age.

Age Factors↗
PubMed1986

Prevalence of depressive and other symptoms in elderly Finnish men.

The prevalence of depressive and other symptoms were studied in Finnish men aged 65 to 84 years and living either in eastern (n = 310) or in southwestern (n = 378) Finland. The Zung self-rating depression scale showed depressed affect, fatigue and suicidal thoughts to be more common in the east, but indecisiveness to be more prevalent in the south-west. The mean of the sum scores in the Zung scale was 37.8 (+/- 8.4) for the eastern and 37.2 (+/- 8.3) for the south-western population, and no differences were found between the areas in this respect. However, many of the other symptoms, including somatic and psychosomatic (such as pains, dyspnea, nausea, impaired memory, apathy, itching skin and sight disturbances) were more common among men living in eastern Finland. The former findings support the idea that there are differences in the affects between men living in the east and men living in the south-west, but, as a whole, depressive symptoms are equally prevalent in both elderly male populations. The latter finding may reflect the well-known differences in the prevalences of somatic diseases between these two areas.

Affective Symptoms↗
PubMed1986

Effects of dietary fat modifications on serum lipids and blood pressure in children.

Some recent studies have shown an extremely high level of serum cholesterol level among Finnish children. The aim of the present study was to test the effect of a "cholesterol lowering diet" on serum lipids and blood pressure among 36 children aged 8-18 years residing in two semirural communities in North Karelia, Finland. After a baseline period of two weeks on conventional diets, the proportion of energy derived from fat in the diet was reduced from the baseline level of 35% to 24%, and the ratio of polyunsaturated/saturated fats was increased from the baseline level of 0.18 to 0.61, during a 12-week intervention period. The children then changed back to their normal diet during a five-week switch-back period. The mean serum total cholesterol decreased 15% during the intervention, and then increased to nearly the initial level during the switch-back period. Similar changes were observed in HDL-cholesterol and also to some extent in apoproteins AI, AII and B. Blood pressure was not affected, although systolic blood pressure decreased during intervention. We conclude that the high level of serum cholesterol in Finnish children is to a great extent caused by the local dietary pattern and can be decreased by dietary modification.

Adolescent↗
PubMed1986

Dietary fats and the management of hypertension.

The role of dietary fat in human hypertension has been of interest recently. Examples of two intervention studies are presented to demonstrate this effect. One study was conducted at Beltsville, MD, and the other at North Karelia, Finland. Healthy people served as subjects for the experiments and the foods consumed by the subjects were typical for the regions. During the intervention periods the percentage of energy from dietary fats was lowered while the polyunsaturated fatty acids were increased. Total energy intake and salt intake were kept relatively constant. Systolic and diastolic blood pressure were decreased during the lowered fat, higher polyunsaturated fatty acids intake period and this effect was reversed during the switchback period. The data give strong support to the hypothesis that dietary fat is associated with blood pressure.

Blood Pressure↗
PubMed1985

Platelet aggregation in Finnish men and its relation to fatty acids in platelets, plasma and adipose tissue.

Platelet aggregation and its relation to fatty acid composition of platelets, plasma and adipose tissue was determined in 196 randomly selected, free-living, 40-49-year-old men in two regions of Finland (east and southwest) with a nearly twofold difference in the IHD rate. There were no significant east-southwest differences in platelet aggregation induced with ADP, thrombin or epinephrine. ADP-induced platelet secondary aggregation showed significant negative associations with all C20-C22 omega 3-fatty acids in platelets (r = -0.26- -0.40) and with the platelet 20: 5 omega 3/20: 4 omega 6 and omega 3/omega 6 ratios, but significant positive correlations with the contents of 18:2 in adipose tissue (r = 0.20) and plasma triglycerides (TG) (r = 0.29). Epinephrine-induced aggregation correlated negatively with 20: 5 omega 3 in plasma cholesteryl esters (CE) (r = -0.23) and TG (r = -0.29), and positively with the total percentage of saturated fatty acids in platelets (r = 0.33), but had no significant correlations with any of the omega 6-fatty acids. Thrombin-induced aggregation correlated negatively with the omega 3/6 omega ratio in adipose tissue (r = -0.25) and the 20: 3 omega 6/20: 4 omega 6 ratio in plasma CE (r = -0.27) and free fatty acids (FFA) (r = -0.23), and positively with adipose tissue 18:2 (r = 0.23) and 20:4 omega 6 (r = 0.22) in plasma phospholipids (PL). The percentages of prostanoid precursors in platelet lipids, i.e. 20:3 omega 6, 20:4 omega 6 and 20:5 omega 3, correlated best with the same fatty acids in plasma CE (r = 0.32 - 0.77) and PL (r = 0.28 - 0.74). Platelet 20:5 omega 3 had highly significant negative correlations with the percentage of 18:2 in adipose tissue and all plasma lipid fractions (r = -0.35 - -0.44).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Diphosphate↗
PubMed1985

Effectiveness of treatment with antihypertensive drugs and trends in mortality from stroke in the community.

A study was made of the changes in the treatment of hypertension, in the effectiveness of that treatment, and in mortality from cerebrovascular stroke in men and women in two counties in Finland. One of these counties was North Karelia, where a comprehensive cardiovascular programme based in the community had been launched in 1972. Cross sectional surveys in large representative samples of the middle aged populations were carried out in 1972, 1977, and 1982. Average annual mortality from stroke adjusted for age was calculated for the two year periods 1971-2, 1977-8, and 1980-1. The proportion of hypertensive men being effectively treated for their hypertension increased in both areas from 1972 to 1977 and further from 1977 to 1982. Mortality from stroke in middle aged men decreased in both areas during both observation periods. The proportion of hypertensive women being effectively treated greatly increased in both areas from 1972 to 1977. This was associated with a large decline in mortality from stroke. In North Karelia the proportion of women being effectively treated was remarkably high but decreased somewhat between 1977 and 1982; this decrease was associated with an increase in mortality from stroke in the women aged 35-64. These results support the idea that effective antihypertensive treatment in the community is a major determinant of mortality from stroke in both men and women.

Adult↗
PubMed1985

Serum fatty acids, apolipoproteins, selenium and vitamin antioxidants and the risk of death from coronary artery disease.

The independent association of serum concentrations of saturated and polyunsaturated fatty acids, apolipoproteins AI and B, selenium and vitamins A and E with the risk of death from coronary artery disease (CAD) was studied in 92 persons with no previous myocardial infarction, who died from CAD during a 5-year follow-up, and their 92 1-to-1 matched controls. Case-control pairs came from a randomly drawn population sample of approximately 12,000 persons aged 30 to 64 years from 2 provinces of eastern Finland, an area with exceptionally high CAD mortality. Control subjects were matched for sex, age, serum cholesterol, mean arterial pressure, tobacco consumption and history of cardiovascular diseases. The persons who died of CAD had lower serum esterified arachidonic acid concentrations before follow-up than the control subjects (41 vs 48 mg/liter, p = 0.05), and this difference was greater for pairs with no chest pain on effort (36 vs 50 mg/liter, p less than 0.05). The adjusted risk of CAD death in persons with a serum polyunsaturated to saturated (P/S) fatty acid ratio of 0.28 or less (in the lowest tertile) was 3.5-fold (95% confidence interval [CI], 1.5 to 8.2) compared with those with higher serum P/s ratios in a multivariate logistic model and 5.6-fold (95% CI 1.6 to 19.8) for pairs with no chest pain on effort. A low serum apolipoprotein AI concentration (1.25 g/liter or less, in the lowest tertile) was associated with a 2.5-fold (95% CI 1.1 to 5.7) adjusted risk of CAD death among the chest pain-free persons.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Risk of cancer in relation to serum concentrations of selenium and vitamins A and E: matched case-control analysis of prospective data.

The independent and joint associations of serum selenium and vitamin A (retinol) and E (alpha tocopherol) concentrations with the risk of death from cancer were studied in 51 case-control pairs--that is, 51 patients with cancer, each paired with a control matched for age, sex, and smoking. Case-control pairs came from a random sample of some 12000 people aged 30-64 years resident in two provinces of eastern Finland who were followed up for four years. Patients who died of cancer during the follow up period had a 12% lower mean serum selenium concentration (p = 0.015) than the controls. The difference persisted when deaths from cancer in the first follow up year were excluded. The adjusted risk of fatal cancer was 5.8-fold (95% confidence interval 1.2-29.0) among subjects in the lowest tertile of selenium concentrations compared with those with higher values. Subjects with both low selenium and low alpha tocopherol concentrations in serum had an 11.4-fold adjusted risk. Among smoking men with cancer serum retinol concentrations were 26% lower than in smoking controls (p = 0.002). These data suggest that dietary selenium deficiency is associated with an increased risk of fatal cancer, that low vitamin E intake may enhance this effect, and that decreased vitamin or provitamin A intake contributes to the risk of lung cancer among smoking men with a low selenium intake.

Adult↗
PubMed1985

When does rheumatoid disease start?

Stored serum specimens collected in connection with a community-oriented epidemiologic study were available from 30 subjects who later developed seropositive rheumatoid arthritis. In 9 of these pre-rheumatoid specimens, the Rose-Waaler test result was positive, and in 16, the latex fixation test was positive. Two-thirds of the samples were positive when the interval between taking the blood specimen and onset of the disease was less than 4 years, and one-third were positive when the interval was greater than or equal to 4 years. The occurrence of rheumatoid factor preceded the onset of clinical disease more often in males than in females.

Adult↗
PubMed1985

Metabolic epidemiology of colon cancer: fecal mutagens in healthy subjects from rural Kuopio and urban Helsinki, Finland.

Fecal mutagenic activity and dietary pattern of rural and urban Finnish population groups with distinct risk for the development of colon cancer were studied in a low-risk population in rural Kuopio and an intermediate-risk population in urban Helsinki. The average daily intake of protein and fat was the same in the two groups but the frequency of consumption of whole-grain cereals and whole-grain bread, as well as the amount of fiber from the bread were higher in Kuopio as compared to Helsinki. Fecal samples collected for 2 days were incubated under anaerobic conditions at 37 degrees C for 96 h, extracted with hexane: peroxide-free diethyl ether, partially purified on a silica Sep-Pak cartridge, and assayed for mutagenic activity using the Salmonella typhimurium/mammalian microsome system. The fecal mutagenic activity was observed with the tester strains TA98 and TA100 with and without microsomal activation in both the population groups. The percentage of samples showing fecal mutagenic ratio greater than 3 with TA98 and TA100 with microsomal activation, was higher in volunteers from Helsinki than in Kuopio.

Adult↗
PubMed1985

Dietary fat and blood pressure: an intervention study on the effects of a low-fat diet with two levels of polyunsaturated fat.

The role of dietary fat in human blood pressure control was studied among 84 middle-aged subjects (mainly couples) in two semirural communities in North Karelia, Finland. The families were randomly allocated into two groups that, after a baseline period of 2 weeks, changed their diet for a 12-week intervention period so that the proportion of energy derived from fats was similarly reduced in both groups, from 38 to 24%, but the polyunsaturated/saturated fatty acid (P/S) ratio was increased--from 0.2 to 0.9 in group I and to 0.4 in group II. After the intervention period, both groups switched back to their usual diet for a period of 5 weeks. During the intervention period, total serum cholesterol was reduced by 16% in group I and 14% in group II. Mean body weight and urinary sodium, potassium, calcium, and magnesium excretion changes were small or nonexistent. Mean systolic blood pressure decreased 4 mm Hg in group I (P less than 0.01) and 3 mm Hg in group II (P less than 0.01), and mean diastolic blood pressure decreased 5 mm Hg (P less than 0.001) and 4 mm Hg (P less than 0.01), respectively. The reductions were reversed during the switch-back period (P less than 0.01). These results confirm previous findings of the blood-pressure-reducing effect of a low-fat/high-P/S diet. Although a number of possible confounding factors can be ruled out, the dietary constituent accounting for the blood pressure change cannot be ascertained definitely. The results showed no significant further blood pressure reduction with more than a moderately increased P/S ratio when the saturated fat intake was markedly reduced.

Adult↗
PubMed1985

Projected effects of high-risk versus population-based prevention strategies in coronary heart disease.

The potential benefits of a high-risk and a population strategy to prevent cardiovascular disease deaths by lowering total serum cholesterol and diastolic blood pressure were estimated. The first strategy concentrates on the top 10% of the risk distribution, and the second strategy changes risk factor distributions of the entire population. With the high-risk strategy, lowering total serum cholesterol 20% and diastolic blood pressure to 90 mmHg would result in a 28% reduction in death from cardiovascular disease. Lowering total serum cholesterol to 190 mg/dl and diastolic blood pressure to 80 mmHg with this strategy would result in a 33 per cent reduction in death from cardiovascular disease. These expected changes approximate those expected by lowering total serum cholesterol by 10% and diastolic blood pressure by 5% with the population strategy. Changes in total serum cholesterol (20% lowering) and diastolic blood pressure (10% lowering) that have been achieved in nutrition intervention trials would result in a 50% decline in cardiovascular disease death rates if applied to the whole population. If population mean total serum cholesterol could be lowered to 190 mg/dl and population mean diastolic blood pressure could be lowered to 80 mmHg, a 70% reduction in cardiovascular disease death rates would be expected. This suggests that only a population approach can prevent the majority of deaths from cardiovascular disease in a community.

Adult↗