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Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 253 records · Page 14Linked to original sources
PubMed1983

Effect of two years of educational intervention on adolescent smoking (the North Karelia Youth Project).

A two-year educational intervention programme was carried out to try to prevent the onset of smoking among 13-15-year-olds in the county of North Karelia in eastern Finland. The aim of the programme was to teach the children skills to resist social pressures towards smoking. Older students (peer leaders) were trained to conduct the programme, which was directly managed in two schools and voluntarily implemented by the staff of about half of the remaining 23 schools in the county. Both types of intervention were associated with a significant reduction in self-reported onset rates of smoking. It is concluded that this type of innovative approach, based on modern psychosocial principles, is needed to control the smoking epidemic among adolescents.

Adolescent↗
PubMed1982

Effect of diet on serum lipoproteins in a population with a high risk of coronary heart disease.

The population of North Karelia, a county in Finland, has a high rate of coronary heart disease. It also has a high prevalence of hypercholesterolemia, but whether this reflects a diet rich in animal fats or is a result of genetic factors is unclear. We studied the effect on serum lipoproteins of a low-fat diet with a high ratio of polyunsaturated to saturated fatty acids in 54 middle-aged volunteers in North Karelia. Total serum cholesterol decreased, from 263 +/- 8 mg per deciliter (mean +/- S.E.) to 201 +/- 5 mg in men (P less than 0.0001) and from 239 +/- 8 to 188 +/- 8 mg in women (P less than 0.0001), along with low-density-lipoprotein cholesterol and apoprotein B. High-density lipoprotein decreased from 54 +/- 2 mg per deciliter to 44 +/- 2 in men (P less than 0.0001) and from 56 +/- 3 to 47 +/- 2 mg in women (P less than 0.0001). A small but significant reduction occurred in serum apoprotein A-I, whereas apoprotein A-II increased slightly. The individual changes in low-density-lipoprotein cholesterol correlated with those in high-density-lipoprotein cholesterol. The changes in serum lipids and apoproteins were reversed when the participants returned to their original diets. Our results suggest that the hypercholesterolemia characteristic of this population is due at least in part to dietary factors.

Adult↗
PubMed1982

Association between cardiovascular death and myocardial infarction and serum selenium in a matched-pair longitudinal study.

A case-control study was conducted to investigate the association between serum selenium and risk of death from acute coronary heart disease (CHD) as well as risk of fetal and non-fetal myocardial infarction (MI). Case-control pairs came from a population of 11,000 persons examined in 1972 from two counties in eastern Finland, an area with an exceptionally high mortality from cardiovascular diseases. Cases were aged 35-59 years and had died of CHD or other CVD or had a non-fetal MI during a seven-year follow-up. Controls were matched for sex, age, daily tobacco consumption, serum cholesterol, diastolic blood pressure, and history of angina pectoris. The mean serum selenium concentration for all cases was 51.8 micrograms/l and for all controls 55.3 micrograms/l (p less than 0.01). Serum selenium of less than 45 micrograms/l was associated with an adjusted relative risk of CHD death of 2.9 (p less than 0.01, 95% CI, 1.4-6.0), a relative risk of CVD death of 2.2 (p less than 0.01, 95% CI, 1.2-4.0), and a relative risk of fatal and nonfatal MI of 2.1 (p less than 0.001, 95% Ci, 1.4-3.1). 22% (95% CI, 8-35%) of contrary deaths were attributable to serum selenium in the whole study population.

Adult↗
PubMed1982

Physical activity and risk of myocardial infarction, cerebral stroke and death: a longitudinal study in Eastern Finland.

Physical activity at work and in leisure time was studied by using a questionnaire in a random population sample from two counties of Eastern Finland in 1972. Data on age, serum cholesterol, diastolic blood pressure, height, weight and smoking were recorded in a field examination. The study population consisted of 3978 men aged 30-59 years and 3688 women aged 35-59 years. The participation rate was 92% in men and 94% in women in these age groups. During the approximately seven-year follow-up until December 31, 1978, 210 men and 63 women had an acute myocardial infarction (AMI), 89 men and 14 women died of acute ischemic heart disease, 71 men and 56 women had a cerebral stroke and 172 men and 75 women died of any disease. The subjects with a history of myocardial infarction, angina or cerebral stroke in the 12 months preceding the baseline survey were excluded in the respective analysis. Low physical activity at work was associated with an increased risk of AMI, cerebral stroke and death due to any disease in both men and women, even when controlling for age, serum total cholesterol, diastolic blood pressure, height, weight and smoking in a multiple logistic model. The relative risk of AMI was 1.5 (90% confidence interval (CI) = 1.2-2.0) in men and 2.4 (90% CI = 1.5-3.7) in women. Low physical activity in leisure time had a significant association with an increased risk of death, but not with an increased risk of AMI or stroke in the multivariate analysis.

Adult↗
PubMed1982

A decline in earning losses associated with a community-based cardiovascular disease prevention project.

Permanent and temporary disability pension award data and survey data were used to estimate the lower bound of earning losses related to cardiovascular disease during a community-based cardiovascular disease prevention program in Eastern Finland. Earning losses due to death totaled $39.94 million but were not affected by the project. Earning losses due to permanent disability totalled +29.01 million and were $4.25 million less than expected (p less than 0.025). Earning losses due to temporary disability were $10.91 million and were not affected by the project. Total earning losses attributable to cardiovascular disease during the project period were $79.86 million, and total decline in earning losses was +4.25 million. Project implementation costs were less than one per cent of total earning losses and were equal to approximately 17 per cent of the decline in these losses attributable to the project. The findings suggest that community-based heart disease prevention programs have the potential of more than paying for themselves through an associated decline in lost earnings.

Adolescent↗
PubMed1982

Serum total cholesterol, HDL cholesterol and blood pressure levels in 13-year-old children in Eastern Finland. The North Karelia Youth Project.

North Karelia Youth Project is a community and school-based intervention study of 13-year-old schoolchildren in Eastern Finland. This paper deals with serum total cholesterol, HDL cholesterol and blood pressure levels with some important background variables in the baseline survey in 1978. A total of 966 children were studied. A high mean serum serum cholesterol level (5.1 mmol/l) among both boys and girls was an outstanding finding. The cholesterol level was higher in the rural than urban areas. Different diet can explain this difference. Mean blood pressure was 117/67 mmHg among girls and 117/63 among boys. The high risk factor levels at this age support strongly the idea that the prevention of cardiovascular diseases should be started already in childhood.

Adolescent↗
PubMed1982

Autoantibodies predicting death due to cardiovascular disease.

A randomly sampled population aged from 25 to 59 years and examined in 1972 was monitored for 5 years. During that period, 126 deaths from cardiovascular causes occurred among subjects with no recent history of major cardiovascular diseases. A control matched for age, sex and the conventional cardiovascular risk factors was assigned to each of the deceased subjects from the same population at risk. Rheumatoid factors or antinuclear antibodies as determined from the baseline specimens were found among 21 of the deceased (20 in the discordant pairs), but only in 7 controls (6 in the discordant pairs). This corresponds to a relative risk of death due to cardiovascular causes of 3.3 (p less than 0.01).

Adult↗
PubMed1982

Theory and action for health promotion illustrations from the North Karelia Project.

The North Karelia Project in Finland illustrates the fundamental goals of health promotion. Specific activities of the project serve as examples of how concepts from the social and behavioral sciences can be applied to achieve estimated reductions in predicted risk of disease. The results in North Karelia are not conclusive, but they are encouraging, and the investigations conducted there is an essential reference for future research in health promotion and disease prevention.

Cardiovascular Diseases↗
PubMed1982

Effects of two years' educational intervention on dietary habits, serum cholesterol and blood pressure among 13 to 15 year old adolescents. The North Karelia youth project.

A school and community based intervention to influence CVD risk factors and promote health in 13 to 15 year old children was carried out in North Karelia, Finland. The intervention was at two levels: 1) an intensive intervention in two schools and 2) a county-wide intervention in the remaining schools. Three pairs of matched schools were evaluated the two intensive intervention schools, two schools representing the county-wide intervention and two reference county schools. 851 children, their parents and teachers were studied before the intervention (1978) and after the intervention in 1980. The effect of intervention on serum and HDL-cholesterol, blood pressure and dietary habits is reported in this paper. The intervention had effect on fat use in both sexes and on total serum cholesterol in girls. Although there were some reported changes in the salt consumption in the desired direction these had no effect on blood pressure levels.

Adolescent↗
PubMed1981

Coronary risk factor clustering patterns in eastern Finland.

A random population sample from Eastern Finland was studied. Altogether approximately 12 000 persons aged 25 to 59 years were examined with participation rate of 92%. Smoking, high saturated fat diet, increased serum cholesterol and elevated blood pressure showed clustering among men but not among women. Smoking tended to cluster in men with high saturated fat intake and hypercholesterolaemia. Increased serum cholesterol clustered with high blood pressure among both men and women. This risk factor clustering may contribute to the exceptionally high coronary heart disease incidence among men in the area. The reverse was true for women: smoking was less prevalent among women with elevated blood pressure or high saturated fat intake and did not differ by serum cholesterol.

Adult↗
PubMed1981

Change in health behaviour in relation to estimated coronary heart disease risk during a community-based cardiovascular disease prevention programme.

The relationship between change in one coronary heart disease risk factor and levels of other risk factors was investigated in independent pre-and post-intervention samples and in a cohort surveyed both before and after a community-based cardiovascular disease prevention programme. A risk score that did not include the factor being analysed for change was developed and used to estimate risk. In the independent samples generally neither change in smoking nor change in saturated fat intake was related to coronary heart disease risk estimated from other factors in either men or women. Only the intake of saturated fats reduced slightly more among the hypertensive than other men (p less than 0.05). In the cohort, only change in smoking by women was related to initial risk estimated from other factors (p less than 0.05). Since change in behaviour had no consistent relation to the preprogramme risk level, it was concluded that health behaviour change in the population was based on common lifestyle changes in th intervention community, and that either face-to-face counselling or new techniques of mass communication are needed to induce high-risk individuals to do more to change their risk-inducing behaviours.

Adult↗
PubMed1981

Changes in smoking, serum cholesterol and blood pressure levels during a community-based cardiovascular disease prevention program--the North Karelia Project.

A comprehensive community-based program to control cardiovascular disease was carried out in North Karelia, Finland, in 1972--1977. Reductions in smoking, serum cholesterol and blood pressure (BP) levels were among the central intermediate objectives. The effect was evaluated by examining independent population samples at the outset and at the end, both in the program area and in a matched reference area. More than 10,000 subjects were studied each time (participation rate about 90%). This paper presents the analyses of the estimated effect of the program on the risk factor means by comparing the baseline and terminal situations among the population aged 30--59 years. The effect of the program among men was estimated to be a reduction of 13% in smoking, 4% in serum cholesterol and 3% in systolic and diastolic BP means. Among women, there was a net reduction of 5% in systolic BP and 4% in diastolic BP means. The net reductions in smoking (8%) and serum cholesterol (1%) among women were within sampling variation. It is concluded that the population means of the major coronary heart disease risk factors were reduced during the program more in the intervention area than in the reference area, and it seems likely that most of this difference was due to the program.

Adult↗