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Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 271 records · Page 15Linked to original sources
PubMed1981

Sodium intake reduction in volunteer families by using a salt substitute and nutrition counselling.

A double-blind study on the home use of regular salt (RS) and a salt substitute, called Mineral Salt (MS), was done in 58 volunteer families all with a 13-year-old child. All the salt used at home was replaced by one of the test salts for 4 months. After the first 2 months the parents were given a 5-hour course on reducing sodium intake by changing food habits. The test salt consumption was measured by weighing the leftover salt after 2 and 4 months. The parents and 13-year-old children collected 24-hour urine samples at the beginning of the study and after 2 and 4 months. The home use of test salt fell from 2.9 to 2.6 g/family member in the RS group (nonsignificant) and from 3.4 to 2.9 g in the MS group (significant at p less than 0.01). There were no statistically significant changes in the sodium or potassium urinary outputs during the study. The results indicate that the home use of MS alone or counselling on changing food habits alone or a combination of the two was not effective enough to reduce sodium intake to a degree detectable by the study methods.

Adolescent↗
PubMed1981

A community-based intervention study on the feasibility and effects of the reduction of salt intake in North Karelia, Finland.

A community-based programme to reduce salt consumption to lower general blood pressure levels has been started in North Karelia, a county eastern Finland with high hypertension and CVD rates. The programme is based on the previous activity in the community to control CVD risk factors (the North Karelia Project). Previously, however, salt reduction was not included among the objectives. The aim of the study is to evaluate the feasibility and effects of this new community programme to reduce salt intake. The study period is from spring 1979 to spring 1982. At the outset and at the end cross-sectional random population samples, ages 14 to 65, are examined both in North Karelia and a matched reference community. The surveys include among other measurements 24-hour urine collection (for Na, K and creatinine excretion) and blood pressure. The effect evaluation is concerned whether the programme reduced the general salt intake and whether this was associated with reduction in blood pressure levels among the population. Principles and methods of intervention are presented. Preliminary results from the baseline survey confirmed the high salt intake of the population: the mean 24-hour urinary Na excretion was 215-218 mmol among men and 171-173 mmol among women. The respective K excretion values were 89-91 mmol and 72-72 mmol, and Na/K ratios 2.5-2.6 and 2.4-2.5.

Adolescent↗
PubMed1980

Community programme for control of hypertension in North Karelia, Finland.

A community-based programme to improve awareness and control of hypertension was launched in 1972 in North Karelia. It was incorporated in the existing health-services system. An assessment five years later showed that, compared with a reference area not included in the programme, awareness of hypertension had improved, the prevalence of hypertension had dropped, levels of blood-pressure were lower by age-group, and the number of people on antihypertensive treatment had increased.

Adult↗
PubMed1980

The role of lay workers in community health education: experiences of the North Karelia project.

The role of natural community leaders in serving as lay health workers in a comprehensive community health programme has been explored. In rural Finland, nearly 300 persons were trained to detect cardiovascular risk factors (smoking, high-cholesterol diet, high blood pressure) in their communities, and to advise community members of the desirability of lowering these risk factors. Initial data from studies of the lay health workers and their intervention work support the concept that carefully select community health workers who are to varying degrees representative of their local populations, can well act as intermediaries in preventive health care strategies.

Attitude to Health↗
PubMed1980

Hypertension control in North Karelia before the intervention of the North Karelia Project.

The baseline survey of the North Karelia Project was carried out to measure the level of cardiovascular risk factors in the target population. These data on the prevalence, detection and treatment of hypertension obtained in the survey were utilized in planning the main programme. The survey was carried out in 1972 and 4275 persons aged from 25 to 59 (6.5% random sample) were examined. The prevalence of hypertension was high--21% of women and 15% of men were judged as being in need of treatment for hypertension. The blood pressure level of men was higher than that of women below 45 years of age, but in all age groups women were more often undergoing treatment. Although majority of people had had their blood pressure checked recently, only half of those who were aware of hypertension had ever been under treatment, and at the time of examination only 13% of those men and 10% of those women had restored normotension. Only one-fifth and one-third of the women who had used drugs had been under treatment for more than 5 years. Thus, the need to provide a systematic hypertension control scheme in North Karelia was urgent, as described in many other communities in the developed world. The main reason for this lies in the inability of the health care system which has not been able to maintain patients on long-term follow-up and treatment.

Adult↗
PubMed1980

Management of hypertension and changes in blood pressure level in patients included in the hypertension register of the North Karelia Project.

A major subprogramme of the North Karelia Project has been the hypertension programme which aimed at lowering the high blood pressure levels prevalent among the whole population of the province of North Karelia, and especially among middle-aged men. A community-based hypertension register, which served as the major tool of the programme, was established to keep patients under treatment and to gather information about the progress of the programme. The registration of the hypertension subjects was continued from 1972 to 1977; the registered patients had annual follow-up examinations. After 5 years of the programme, there were approximately 17 000 registered patients, which was 9.7% of the total population. The proportion of drop-outs at the annual follow-up examinations was 10-20%. 83% of the registered hypertensive subjects were undergoing drug treatment after 3 years' intervention. The percentage of normotensive subjects increased significantly year by year.

Adult↗
PubMed1980

Controlling risk factors in cardiovascular diseases.

In response to community demands to do something about the highest rates of cardiovascular diseases in the world that were found in the country of North Karelia, Finland, a comprehensive community control programme was set up in 1972. The main objective was to reduce the high rates by reducing level of smoking, serum cholesterol and blood pressure. The success of the programme was evaluated by examining independent representative population samples in 1972 and in 1977 in North Karelia and a matched control county. A decrease in the individual risk factors was found among the population aged 25-29 at the outset. This reduction was mainly based on favourable changes in lifestyle that took place through the whole community. In low as well as in high socioeconomic groups risk factor reductions occurred. At the same time morbidity and mortality from cardiovascular diseases fell in North Karelia. The intensified health education was not accompanied by adverse emotional or psychosomatic reactions that could be measured. Since there are results from a series of experimental and controlled studies on success of risk factor reduction, this evidence should be used in development and implementation of prevention programmes for cardiovascular diseases. Primary prevention of cardiovascular diseases today requires efficient programmes because they are forming the leading cause of death in majority of the countries where reliable mortality statistics are available.

Adult↗
PubMed1980

A community programme for rehabilitation and secondary prevention for patients with acute myocardial infarction as part of a comprehensive community programme for control of cardiovascular diseases (North Karelia Project).

The comprehensive community programme for the control of cardiovascular diseases in North Karelia includes a special subprogramme for the rehabilitation and secondary prevention among patients with an acute myocardial infarction (AMI). The target group of the programme were persons under the age of 65 who had an AMI according to the community-based AMI register and had survived the acute phase of the disease. The programme consisted of systematic long-term medical follow-up at an outpatient MI clinic and of decentralized local group-rehabilitation with special emphasis on secondary prevention. The main component of the programme were health education and submaximal physical exercise, aiming at the reduction of the known secondary risk factors and the improvement of the general well-being of the patients. The feasibility of this programme was good. During the five-year period from 1973 to 1977 a total of 1308 persons under the age of 65 survived an AMI. Out of these patients 515 visited the outpatient MI clinic and 575 took part in the rehabilitation groups. The participation rate in the rehabilitation groups in the whole community increased during the period from 24% to 63%. During the programme period there was a reduction in incidence of recurrent infarctions and new vocational invalidity pensions among the patients with AMI.

Adult↗
PubMed1979

Changes in coronary risk factors during comprehensive five-year community programme to control cardiovascular diseases (North Karelia project).

A comprehensive community programme to control cardiovascular diseases (CVD) in North Karelia, Finland, was carried out during 1972-7. The central intermediate objective of the programme was to reduce the prevalence of smoking, the serum cholesterol concentration, and raised blood-pressure values among the population of the area. The effect was evaluated by examining independent representative population samples in 1972 and 1977 in both the county of North Karelia and a matched control county. Over 10 000 subjects were studied each time, the participation rate being around 90%. The decrease that occurred in the risk factors, especially in men, was in general greater in North Karelia compared with the control county. When a multiple logistic function was used for the three risk factors an overall mean net reduction of 17% among men and 12% among women was observed in the estimated risk for coronary heart disease in North Karelia. This community programme effectively reduced the levels of the three main risk factors for CVD in the population, and thus mortality and morbidity from CVD should fall. This is assessed in further studies.

Adult↗
PubMed1979

Changes in morbidity and mortality during comprehensive community programme to control cardiovascular diseases during 1972-7 in North Karelia.

A comprehensive community programme studying the control of cardiovascular diseases (CVD) was carried out in North Karelia, Finland, between 1972 and 1977. The main objective was to reduce the mortality and morbidity of CVD, particularly in middle-aged men. Changes in the mortality and incidence of CVD were monitored by community-based registers of cases of acute myocardial infarction (AMI) and stroke and data on death certificates. During the programme the total mortality in the area decreased by 5% and the mortality from CVD decreased by 13% among men and 31% among women aged 30-64 years. The incidence of AMI fell by 16% among men and 5% among women, while that of cerebral stroke fell by 38% among men and 50% among women. Changes in mortality in North Karelia were compared with those in a matched control area; the difference between the two areas was not significant. The true effect of the programme cannot be deduced from these results, but mortality from CVD and the incidence of AMI and stroke fell during the five years studied. Thus the changes in mortality and morbidity of CVD accorded with the initial objectives of the programme.

Adult↗