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Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 235 records · Page 13Linked to original sources

Prostanoids in blood pressure regulation and their role in the blood pressure lowering effects induced by changes in dietary fats.

It has been suggested that deficient formation of vasodilatory prostanoids may be involved in the pathogenesis of hypertension. PUFA can be a source of arachidonic acid, which is partly converted into prostanoids. Increasing the dietary amount of PUFA has been consistently shown to decrease blood pressure in animals and man. The mechanism of the blood pressure lowering action, however, is not clear. We have found that a diet rich in PUFA can lower blood pressure but at the same time reduce the formation of those vasodilatory prostanoids which nowadays are regarded as the most active ones in the circulatory regulation.

Adult↗

Treatment of vitiligo with oral methoxsalen and UVA.

139 patients with vitiligo of long duration were treated with oral 8-MOP and UVA. 22 patients had focal and 117 generalized vitiligo. 27 had vitiligo on the skin of their face and/or neck and 58 on their hands and/or feet. Vitiligo of the face and/or neck responded very well to the treatment, 14 of 27 (52%) repigmenting completely, while the treatment results of hands and/or feet were poor (complete repigmentation in 2 of 58 cases (3%). In cases with focal vitiligo total repigmentation was observed much more frequently (in 11 of 22 cases) than in cases with generalized vitiligo (in 23 of 117 cases). Acute toxic effects were frequent, erythema in 55 cases (40%), nausea in 46 cases (33%), pruritus in 16 cases (12%) and headache in 8 cases (6%). Long-term adverse effects such as hypertrichosis and actinic keratoses occurred in 3 cases each. 6 patients (4%) had elevated transminases at some stage of the treatment. This did not cause withdrawal from treatment in any of the cases.

Administration, Oral↗

Projected population effects of a nutritional blood pressure intervention on death rates from cardiovascular disease.

Evidence is accumulating that blood pressure can be modified by dietary changes. To test whether dietary manipulation could have an important effect on CVD death rates in a population, we used the logistic risk function to project the effects of pharmacological and dietary intervention. Successful pharmacological control of 60%, 80%, and 100% of the population with diastolic blood pressure values of 90 mm Hg or more is projected to result in 11%, 14%, and 18% reductions in CVD death rates, respectively. Reducing dietary fat to 23% and increasing the P/S ratio to 0.98 is projected to result in a 47% reduction in CVD death rates. The dietary intervention is projected to reduce the population requiring medication by 50% and reduce costs of hypertension treatment by 30%. On the basis of these projections, we conclude that dietary interventions for hypertension control can have an important effect both on death rates and treatment costs.

Adult↗

Dietary intervention study among 30 free-living families in Finland.

A dietary intervention study to reduce risk factors for coronary heart disease was carried out among 30 free-living middle-aged couples in North Karelia, Eastern Finland. During the study, the subjects changed their normal diet for six weeks. The main changes in the diet were decrease in the consumption of fat (from 39% to 24% of total calories), increase in the P:S ratio from 0.15 to 1.22, and increased consumption of fruit and vegetables. The changes in the food consumption pattern were facilitated by giving the families free food items, such as skim milk, vegetable margarine, vegetables, and fruit. The food consumption and nutrient intakes were measured by food consumption records kept every other day. Also, duplicate diets were collected once during each study period for chemical analysis. Compliance with the dietary changes was better than expected, and the acceptability and the palatability of the diet were reported to be good. The decrease in the fat content of the diet increased the nutrient density of the diet; i.e., the concentration of vitamins and minerals improved. This study showed how even more drastic dietary changes than those recommended by health authorities can be realized among ordinary Finnish people.

Adult↗

Change in risk factors for coronary heart disease during 10 years of a community intervention programme (North Karelia project).

A comprehensive community based programme to control cardiovascular diseases was started in North Karelia, Finland, in 1972. Reductions in smoking, serum cholesterol concentrations, and blood pressure were among the central intermediate objectives. The effect of the programme during the 10 year period 1972-82 was evaluated by examining independent random population samples at the outset (1972) and five (1977) and 10 (1982) years later both in the programme and in a matched reference area. Over 10 000 subjects were studied in 1972 and 1977 (participation rate about 90%) and roughly 8000 subjects in 1982 (participation rate about 80%). Analyses were conducted of the estimated effect of the programme on the risk factor population means by comparing the baseline and five year and 10 year follow up results in the age range 30-59 years. The effect of the programme (net reduction in North Karelia) at 10 years among the middle aged male population was estimated to be a 28% reduction in smoking (p less than 0.001), a 3% reduction in mean serum cholesterol concentration (p less than 0.001), a 3% fall in mean systolic blood pressure (p less than 0.001), and a 1% fall in mean diastolic blood pressure (p less than 0.05). Among the female population the reductions were respectively, 14% (NS), 1% (NS), 5% (p less than 0.001), and 2% (p less than 0.05). During the first five years of the project (1972-7) the programme effectively reduced the population mean values of the major coronary risk factors. At 10 years the effects had persisted for serum cholesterol concentrations and blood pressure and were increased for smoking.

Adult↗

Decline in mortality from coronary heart disease in Finland from 1969 to 1979.

The trends in mortality from coronary heart disease in the 1970s and the differences in trends between counties within Finland were calculated from official mortality statistics among the population aged 35 to 64 years. During this period coronary mortality declined by a mean of 1.1% for men and 2.3% for women annually in the whole of Finland. A community based cardiovascular control programme was started in 1972 in North Karelia, a county in the east of Finland. The decline in coronary mortality in this county between 1969 and 1979 was 24% in men and 51% in women. The decline in the rest of Finland over the same period was 12% in men and 24% in women. The decline in North Karelia was greater than that in other counties of Finland for both men and women and that difference exceeded random variation, with over 95% likelihood for both sexes. Even with adjustment for rates before 1974 with cross-county multiple regression analyses the difference persisted. Although further studies are needed, the changes in coronary mortality in North Karelia suggest that the preventive programme has been effective.

Adult↗

Controlled, randomised trial of the effect of dietary fat on blood pressure.

57 couples living in two communities of North Karelia, aged 30-50 years, were randomly allocated to three groups. After a 2-week baseline period group I followed a diet low in fat (23% of energy) with a high polyunsaturated/saturated (P/S) ratio (1 . 0), group II reduced daily salt intake from 192 mmol to 77 mmol, and group III (control group) continued the usual diet. After the 6-week intervention period groups I and II reverted to their usual diets. In group I systolic blood pressure declined from 138 . 4 to 129 . 5 mm Hg and diastolic blood pressure from 88 . 9 to 81 . 3 mm Hg during the intervention period; the values rose during switch-back. The fall was greater among hypertensive than among normotensive subjects. In groups II and III the mean blood pressure changed very little during the study.

Adult↗

Evaluating community-based preventive cardiovascular programs: problems and experiences from the North Karelia project.

Among the different approaches to the study of cardiovascular disease prevention are community-based programs. This type of program concerns a whole community and the intervention takes advantage of the existing service structure and community organization. The evaluation assesses the feasibility, effects on risk factor and disease reduction, costs, process, and other consequences associated with the program. Several such programs have recently been launched in the United States and some other countries. The first major community-based control program was the North Karelia project in Finland, started in 1972 and recently evaluated for its first five-year period. This paper discusses the problems in evaluating community-based CVD control programs on the experiences obtained in the North Karelia project.

Adult↗

Intake of spirits and beer and risk of myocardial infarction and death--a longitudinal study in Eastern Finland.

Intake of spirits and beer as well as smoking was measured by questionnaire in a random population sample from two counties of Eastern Finland in 1972. At the same time serum cholesterol, triglycerides and blood pressure were measured in a field examination. The study material consists of 4063 men aged 30-59 years (participation rate 92%). During a 7-yr follow-up 209 of these men had developed an acute myocardial infarction (AMI) and 223 men had died. Reported spirits and beer intake had both a strong positive association with smoking and serum triglycerides, a weak positive association with diastolic blood pressure, but no relationship to serum total cholesterol. Use of spirits at least once a week was associated with a reduced risk of AMI. The relative risk (RR), adjusted for age and conventional coronary risk factors was 0.5 (95% confidence interval (CI), 0.3-0.9). Consumption of beer had no significant relationship to the risk of AMI. Consumption of at least five bottles of beer a week was related to a slightly excessive risk of death from any cause (adjusted RR = 1.5, 95% CI = 1.0-2.1). Spirits intake had no significant association with the risk of death.

Adult↗

Decrease of serum total and free testosterone during a low-fat high-fibre diet.

The concentrations of serum total and free testosterone were studied in 30 healthy, middle-aged men during a dietary intervention program. When men were transferred from their customary diet to an experimental diet, which contained less fat with a higher polyunsaturated/saturated ratio (P/S-ratio) and more fibre, there was a significant decrease in serum total testosterone concentrations (22.7 +/- 1.2 vs 19.3 +/- 1.1 nmol/l SEM, P less than 0.001). Furthermore, serum free, unbound testosterone fell from 0.23 +/- 0.01 to 0.20 +/- 0.01 nmol/l SEM (P less than 0.01). The hormonal changes were reversible. This observation suggests that testosterone activity in plasma can at least partly be modified by changing the composition of the diet.

Dietary Fats↗

Effect of dietary fat on blood pressure in a rural Finnish population.

Thirty couples living in Liperi, a community of North Karelia, aged 40 to 50 yr participated in a dietary intervention study to assess the influence of dietary fat on blood pressure and other parameters. After a weeklong base-line period the subjects consumed a low fat diet (24% of energy) with a polyunsaturated/saturated fat ratio (P/S) of 1.2 for 6 wk. After this 6-wk intervention period the subjects resumed their normal diets (36% energy from fat, P/S 0.15) for an additional 6-wk period. Body weight remained constant throughout the study and salt intakes were approximately 12 g/day. During the low fat, high P/S period a decrease of 7.5 and 2.8 mm Hg pressure occurred for systolic and diastolic blood pressure from the base-line level. When the normal diet was resumed, systolic and diastolic blood pressures increased by 7.7 and 6.3 mm Hg, respectively, from the levels observed at the end of the intervention period.

Adult↗

Relation of serum cholesterol and triglycerides to the risk of acute myocardial infarction, cerebral stroke and death in eastern Finnish male population.

A random population sample from two countries of eastern Finland was studied in 1972, measuring eg the serum total cholesterol and triglycerides, blood pressure, and smoking. The participation rate among men aged 30 to 59 was 92%. Men who had had a myocardial infarction, angina or cerebral stroke in the preceding 12 months were excluded. During the seven-year follow-up 211 men had an acute myocardial infarction (AMI), 59 men had a cerebral stroke and 185 men died of any disease. The serum total cholesterol (greater than or equal to 8.0 mmol/l) had a positive association with the risk of AMI (relative risk RR = 2.8, 95% Cl = 1.8-4.3) and the risk of death (RR = 2.2, 95% Cl = 1.3-3.7) among men aged 30-49 but only with the risk of AMI (RR = 2.0, 95% Cl = 1.3-3.1) among those aged 50-59 based on multiple logistic models including also age, serum triglycerides, diastolic blood pressure, smoking and obesity. Serum triglycerides (greater than or equal to 2.8 mmol/l) had a positive risk factor-adjusted association with the risk of cerebral stroke (RR = 2.7, 95% Cl = 1.0-7.1) among men aged 30-49, but no independent association with the risk of AMI or death.

Adult↗

Serum HDL cholesterol in a high coronary risk population in eastern Finland.

The serum high density lipoprotein (HDL) and total cholesterol levels and their determinants were explored in a random population sample from eastern Finland, an area with an exceptionally high mortality and morbidity from coronary heart disease (CHD). A total of 1792 persons aged 14-65 years were studied. Serum HDL cholesterol was determined in one series by using an enzymatic method after precipitation by dextran-magnesium chloride. The mean serum HDL cholesterol was 1.41 mmol/l in men and 1.62 mmol/l in women. Although a multivariate linear regression model explained 21% (for men) and 28% (for women) of the variation in serum total cholesterol, the same variables were able to account for only 9 and 4%, respectively, of the variation in serum HDL cholesterol. Among men, obesity and the daily consumption of tobacco products were inversely associated and the weekly consumption of beer and age were directly associated with serum HDL cholesterol and the serum HDL cholesterol/total cholesterol ratio.

Adolescent↗

Is there an association between serum cholesterol and blood pressure changes?

A community-based programme to influence the risk factors of coronary heart disease was carried out in North Karelia, Eastern Finland in 1972-77. The evaluation, based on examination of large cross-sectional random samples at the outset and at the end of the period, showed a greater reduction in both serum cholesterol and blood pressure levels in North Karelia than in a matched reference area. A random cohort of 293 men and 321 women who were studied both in 1972 and in 1977 did not use antihypertensive drugs on either occasion. Among these people the change in blood pressure was positively associated with the change in serum cholesterol even when age, initial blood pressure, changes in body mass and number of blood pressure measurements were allowed for. This finding supports the hypothesis that changes in fat consumption lead to changes in blood pressure, but this hypothesis needs further investigation.

Adult↗