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Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 55 records · Page 3Linked to original sources
PubMed2000

Cardiovascular risk factor changes in Finland, 1972-1997.

BACKGROUND: The cardiovascular risk factor levels of the population have been assessed in Finland since 1972. In the beginning the surveys were done to evaluate the North Karelia Project, which was a community-based preventive programme. A national cardiovascular disease (CVD) prevention strategy was developed and implemented during the late 1970s. Subsequently, a national cardiovascular risk factors monitoring system was developed to assess the effectiveness of the national strategy. METHODS: Cross-sectional population samples were studied in 1972 and 1977 in North Karelia and Kuopio provinces in eastern Finland. An area in southwestern Finland was included in 1982, followed by the Helsinki metropolitan area in 1992 and Oulu province in northern Finland in 1997. A total of 19 761 men and 20 761 women aged 30-59 participated in the six surveys (1972, 1977, 1982, 1987, 1992, 1997). RESULTS: The serum cholesterol levels of both genders have continuously declined. Systolic blood pressure levels have declined since 1972, but no further decline in diastolic blood pressure was found in 1997. Smoking prevalence among men continued to decline mainly due to an increase in the percentage of never-smokers. For the first time the increase in smoking prevalence among women levelled off and started to decline, mainly because the number of female quitters had increased. CONCLUSIONS: These data suggest that the cardiovascular health programme in Finland has succeeded in decreasing the general risk factor level of the population.

Adult↗
PubMed2000

International Quit and Win 1996: comparative evaluation study in China and Finland.

OBJECTIVES: To compare background and process variables, as well as follow up status, of the participants in the International Quit and Win '96 contests of China and Finland, and analyse factors contributing to sustained maintenance. DESIGN: A standardised 12 month follow up was conducted in both countries with random samples of participants. The sample sizes were 3119 in China and 1448 in Finland, with response rates of 91.2% and 65.2%, respectively. INTERVENTIONS: The International Quit and Win '96 contest was the second coordinated, multinational smoking cessation campaign targeted at adult daily smokers. Altogether 25 countries participated, including China with 15 000 and Finland with 6000 smokers registered. MAIN OUTCOME MEASURES: Conservative (considering all non-respondents relapsed) and non-conservative (based on respondents only) estimates were calculated for one month abstinence, 12 month continuous abstinence, and point abstinence at the time point of follow up. RESULTS: Great differences were found in the background and process variables, as well as in the outcome measures. At one year follow up, the conservative continuous abstinence rates show that the Chinese participants maintained their abstinence better (38%) compared to the Finnish ones (12%). In China women reached higher abstinence rate (50%) than men (36%), whereas in Finland men achieved a better result (14%) than women (9%). CONCLUSIONS: The Quit and Win contest is a mass smoking cessation method feasible in countries showing great variance in smoking habits and rates. However, in countries with different stages of anti-smoking development, such as China and Finland, different practical implementation strategies may be needed.

Adolescent↗
PubMed2000

High serum cholesterol and risk of suicide.

OBJECTIVE: The study was conducted to estimate the association between serum total cholesterol concentration and mortality from suicide. METHOD: The baseline serum total cholesterol concentration of 37,635 adults was determined in five independent population surveys conducted during 1972-1992 in Finland. Mortality from different causes of death was monitored for a mean of 14.6 years after the survey dates. The means for violent suicides (N=130) included hanging, firearms, cutting, jumping, and unspecified means. The means for nonviolent suicides (N=46) included drug overdose, poisoning with gases, and drowning. RESULTS: Serum total cholesterol concentration was positively related to the risk of violent suicide. Among subjects whose serum total cholesterol concentration was in the highest category, the adjusted relative risk was more than twofold compared with the lowest category. The violent/nonviolent suicide ratio increased linearly with increasing cholesterol category. No association between serum total cholesterol concentration and the risk of nonviolent suicide was found. CONCLUSIONS: This is the first study to demonstrate the positive relationship of high serum total cholesterol concentration with increased risk of violent suicide.

Adult↗
PubMed2000

Nutrition and mortality: the Finnish experience.

This paper reviews the Finnish experience concerning nutrition and mortality. In the early 70's major activities were started to change national nutritional habits, particularly in view of reducing the high mortality of cardiovascular diseases. At the same time a comprehensive monitoring system was developed. During the period from 1972 to 1997 major changes took place in national nutrition, in accordance with the set objectives. Associated with this, major reduction was observed in national CVD mortality. The Finnish experience gives great support to the hypothesis that population rates of cardiovascular diseases can be substantially influenced by changes in people's dietary habits.

Accidents↗
PubMed2000

Smoking and the risk of suicide.

OBJECTIVE: To estimate the relationship between cigarette smoking and the risk of suicide. METHOD: The mortality of 36527 adult men and women was monitored for the mean 14.4 years. Information on deaths caused by suicide was obtained from the National Mortality Register. Suicides were subclassified by the level of violence used. Current smokers of 1-20 cigarettes per day were considered light/moderate smokers and heavy smokers were defined as those smoking > or =21 cigarettes per day. RESULTS: There were 134 suicides among 17798 men and 31 suicides among 18729 women. The most common suicide methods were hanging, firearms and drug overdose. According to the Cox model the adjusted relative risk of both violent and non-violent suicide was significantly and linearly increased among light/moderate and heavy smokers compared with non-smokers. CONCLUSION: Smoking was associated with an increased risk of suicide irrespective of the level of violence used.

Adult↗
PubMed2000

International Quit and Win: successful global action for smoking cessation.

Quit and Win has rapidly grown in popularity as a practical international smoking cessation activity. This is likely to be due to Quit and Win's unique, positive approach to a problem that is receiving increasing attention worldwide as a major health threat. The campaign is also a concrete channel for large international health collaboration, which is necessary considering the global nature of marketing efforts of the tobacco industry. Based on encouraging experiences of three previous international campaigns in 1994, 1996 and 1998, the next International Quit and Win will be organized in 2000. It will be larger than ever and support the new WHO Tobacco-Free Initiative.

Global Health↗
PubMed2000

Changes in serum enterolactone, genistein, and daidzein in a dietary intervention study in Finland.

Phytoestrogens are plant-derived compounds that may have cancer-protective properties. The purpose of the study was to see how enterolactone, daidzein, and genistein serum concentrations reflect major changes in the diet of Finnish subjects. Phytoestrogen concentrations were measured by time-resolved fluoroimmunoassay after hydrolysis and extraction in samples from 85 middle-aged subjects who were part of a 12-week dietary intervention study carried out in North Karelia, Finland. In the baseline and the switchback periods, the subjects consumed their habitual Finnish diet, which is high in saturated fat and low in polyunsaturated fat and vegetables. During the 12-week intervention period, the proportion of dietary energy derived from fat was reduced from approximately 39% to 23%, and the consumption of vegetables, fruit, and berries was markedly increased. Enterolactone concentrations were measured during the baseline, intervention, and switchback periods. The median concentration of enterolactone rose from 12.2 to 19.5 nmol/l (P = 0.002) during the low-fat, high-vegetable diet. Daidzein and genistein concentrations were very low and did not change during the intervention. At baseline, 65% of the population had a low serum enterolactone concentration of <15 nmol/l. During the intervention period, this proportion fell to 34%. These major differences in serum enterolactone concentrations suggest that enterolactone may be used as a biomarker of a healthy diet containing plenty of vegetables, fruit, and berries.

4-Butyrolactone↗
PubMed1999

Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14 786 middle-aged men and women in Finland.

BACKGROUND: Coronary heart disease (CHD) is markedly more common in men than in women. In both sexes, CHD risk increases with age, but the increase is sharper in women. We analyzed the extent to which major cardiovascular risk factors can explain the sex difference and the age-related increase in CHD risk. METHODS AND RESULTS: The study cohort consists of 14 786 Finnish men and women 25 to 64 years old at baseline. The following cardiovascular risk factors were determined: smoking, serum total cholesterol, HDL cholesterol, blood pressure, body mass index, and diabetes. Risk factor measurements were done in 1982 or 1987, and the cohorts were followed up until the end of 1994. The Cox proportional hazards model was used to assess the relation between risk factors and CHD risk. CHD incidence in men compared with women was approximately 3 times higher and mortality was approximately 5 times higher. Most of the risk factors were more favorable in women, but the sex difference in risk factor levels diminished with increasing age. Differences in risk factors between sexes, particularly in HDL cholesterol and smoking, explained nearly half of the difference in CHD risk between men and women. Differences in serum total cholesterol level, blood pressure, body mass index, and diabetes prevalence explained about one-third of the age-related increase in CHD risk among men and 50% to 60% among women. CONCLUSIONS: Differences in major cardiovascular risk factors explained a substantial part of the sex difference in CHD risk. An increase in risk factor levels was associated with the age-related increase in CHD incidence and mortality in both sexes but to a larger extent in women.

Adult↗
PubMed1999

Serum cholesterol trends among members of the Finnish parliament.

UNLABELLED: BACKGROUND. Mortality from coronary heart disease in Finland has declined remarkably since the early 1970s. Most of the change has apparently been due to the active national strategy for reduction of serum cholesterol levels. This study was undertaken to estimate to what extent members of the Finnish parliament (MPs) have complied with the national recommendations. METHODS: Serum total and HDL cholesterol values were measured from MPs of three subsequent parliaments elected in 1987, 1991, and 1995. RESULTS: From 1987 to 1995, the Finnish MPs showed a reduction of serum total cholesterol that was significant among males (-5.2;%, P < 0.05) but not among females (-6.4%, NS) and was somewhat smaller than the reduction in the general population during 1987 to 1997 (-9.4% among males and -8. 3% among females). The male MPs had a 14% rise in HDL cholesterol (P < 0.01), while among female MPs and in the general population it decreased by 3.1 to 3.8% (all NS). The cholesterol levels of female MPs were altogether a little lower than in the general population. The Finnish MPs tended to have lower total cholesterol levels compared with those reported from Hungarian MPs. CONCLUSION: The favorable change in the lipid profile of members of the Finnish parliament indicates that they have personally been involved in the national change process. Follow-up of risk factors in national decision-makers is a useful part of comprehensive monitoring of national coronary heart disease prevention activity.

Adult↗
PubMed1999

Cardiovascular diseases and risk factors in Finland.

We summarize here the evidence from the 1960s and 1970s of exceptionally high risk of cardiovascular disease (CVD) in Finland. In parallel with voluntary and governmental prevention programs, the level of risk factors and CVD attack rates have shown dramatic improvement in the past 25 years, but the decline has slowed in recent years. This experience strongly supports population-wide strategies for primary prevention, and it also highlights the continued need for primordial prevention directed toward youth in high-risk societies.

Cardiovascular Diseases↗
PubMed1999

Changes in blood pressure, body mass index, and salt consumption in a Chinese population.

BACKGROUND: The prevalence of hypertension among the population of Tianjin is one of the highest in China. We attempted to assess the changes in blood pressure, body mass index, and salt consumption in Tianjin from 1989 to 1996. METHODS: Two independent cross-sectional population surveys with the representative samples of 14,046 persons in 1989 and 2,000 persons in 1996 were carried out in Tianjin. A salt surveillance system was established with four salt consumption surveys (in 1992, 1993, 1994, and 1996) to estimate the changes in salt consumption at the household level. RESULTS: From 1989 to 1996, the prevalence of hypertension and obesity decreased among people aged 45-64 years in both genders. Mean systolic blood pressure decreased significantly in women and leveled off in men. Diastolic blood pressure increased significantly. Body mass index remained unchanged. The unfavorable trends were mainly attributable to the negative changes in younger people (15-34 years) in both genders. There were no changes in salt consumption between 1992 and 1996 at the house level. CONCLUSIONS: There was a favorable development in prevalence of hypertension and obesity among individuals in the age group of 45-64 years in the study population. Health education needs to pay more attention to young people.

Adolescent↗
PubMed1999

Optic disc changes in normotensive persons with unilateral exfoliation syndrome: a 3-year follow-up study.

BACKGROUND: If, at the time of glaucoma diagnosis, the intraocular pressure (IOP) is higher and the initial field loss more advanced in glaucomatous eyes with than without exfoliation, the cause of the optic disc damage has been suggested to be the high IOP associated with the exfoliation syndrome (EXS). We decided to investigate whether EXS alone, without the contributory effect of measured raised IOP, is a risk factor for optic nerve damage. METHODS: Twenty-two non-glaucomatous, normotensive persons with clinically unilateral EXS were examined for IOP, visual fields (Octopus G1) and disc topography (Imagenet, Topcon) and followed up for 3 years. RESULTS: At the start, the paired exfoliative (E) and non-exfoliative (NE) eyes did not differ in IOP, disc, rim, or cup areas, or cup volumes. They differed in R/D (rim/disc) radius ratio in the inferior section of the optic disc. During the follow-up period, the IOP increased in the E and the NE eyes, and changes indicative of nerve fiber loss were measured in both eyes. In those (n=14) in whom the IOP in the two eyes was equal throughout the follow-up period, disc changes took place only in the E eye. CONCLUSION: The exfoliative process in itself may be a risk factor for optic disc changes.

Aged↗
PubMed1999

Retinol, vitamin D, carotenes and alpha-tocopherol in serum of a moderately hypercholesterolemic population consuming sitostanol ester margarine.

We have shown earlier that sitostanol ester margarine lowers serum cholesterol by inhibiting cholesterol absorption so that, theoretically, there could be interference with the absorption of fat-soluble vitamins. Accordingly, we investigated whether sitostanol ester margarine affects the serum levels of vitamin D, retinol, alpha-tocopherol and alpha- and beta-carotenes during 1-year treatment in 102 subjects and 49 controls with moderate hypercholesterolemia. The vitamins were assayed at baseline on home diet, on margarine alone, after 1 year's consumption of sitostanol ester margarine and after an additional 2 months on home diet. In the sitostanol group, serum plant sterols, indicators of cholesterol absorption efficiency, were reduced up to -38% in relation to controls from home diet (P < 0.01) indicating that cholesterol absorption was markedly reduced. Vitamin D and retinol concentrations and the ratio of alpha-tocopherol to cholesterol were unchanged by sitostanol ester. Serum beta-carotenes and alpha-carotene concentration but not proportion were reduced in the sitostanol group from baseline and in relation to controls (P < 0.01). Retinol and vitamin D were unassociated with serum cholesterol, plant sterols or other vitamins, whereas alpha-tocopherol and carotenes were significantly associated with serum plant sterols suggesting that the higher cholesterol absorption efficiency, the higher the alpha-tocopherol and carotene levels in serum. We conclude that sitostanol ester did not affect vitamin D and retinol concentrations and alpha-tocopherol/cholesterol proportion, but reduced serum beta-carotene levels. Alpha-tocopherol and carotenes, but not vitamin D and retinol, were related to serum cholesterol and cholesterol absorption.

Adult↗
PubMed1999

Smoking cessation advice from health professionals: process evaluation of a community-based program.

The study assessed whether exposure to advice to quit smoking from health care professionals was greater in North Karelia, an area with a community-based, long-term intervention integrated within the health care structure, than in the rest of Finland. Data were collected by health behavior surveys during 1978-1995. Adult regular smokers and those who had quit during the preceding 12 months were surveyed. We measured exposure to cessation advice by questioning, whether the person had been advised by a doctor or public health nurse to give up smoking at least once during the year preceding the survey. Men from the intervention area had a significantly higher likelihood of having been advised to quit than those elsewhere in Finland. The same trend emerged among women, but it was not significant. It is concluded that a community-based intervention program can encourage health professionals to increase their smoking cessation advice.

Adult↗
PubMed1999

Prospective evaluation of external ocular microbial growth and aqueous humor contamination during cataract surgery.

PURPOSE: To analyze the route of aqueous humor contamination leading to the development of postoperative endophthalmitis. SETTING: Department of Ophthalmology, University of Helsinki, Finland. METHODS: Forty-nine eyes of 49 patients (31 having phacoemulsification and 18 extracapsular cataract extraction [ECCE]) participated in the study. Four bacterial cultures were taken: preoperative conjunctival swab, lid margin culture, intraoperative lacrimal lake sample, and immediate postoperative anterior chamber fluid sample. RESULTS: Preoperative lid margin cultures were positive in 59.2% of eyes, conjunctival cultures in 69.4%, and lacrimal lake cultures in 24.9%. Four aqueous humor samples (8.2%) showed bacterial growth in the anterior chamber aspirate: 3 in the phacoemulsification and 1 in the ECCE group. The bacteria isolated in this study, Staphylococcus epidermidis and Propionibacterium acnes (2 positive isolates each) were sensitive to the preoperative topical antibiotics used. No aqueous humor sample or any from other locations showed gram-negative microbe growth. The most frequently recovered microbes in all samples collected from the 3 other sources were S epidermidis and other coagulase-negative staphylococcus species, followed by P acnes and other propionibacterium species. Staphylococcus aureus, and diptheroids. CONCLUSION: The ocular surface significantly contributed to the transmission of microbes into the eye during cataract surgery. These microbes could not be eradicated by topical preoperative antibiotics. However, no patient developed postoperative endophthalmitis. Natural defense mechanisms appear to fend off a minor inoculum with these microbes of relatively low pathogenicity.

Anti-Bacterial Agents↗
PubMed1999

The validity of the routine mortality statistics on coronary heart disease in Finland: comparison with the FINMONICA MI register data for the years 1983-1992. Finnish multinational MONItoring of trends and determinants in CArdiovascular disease.

We compared the diagnoses obtained from the routine mortality statistics with the standardized World Health Organization (WHO) MONICA (multinational MONItoring of trends and determinants in CArdiovascular disease) classification in suspect coronary heart disease (CHD) deaths registered in the FINMONICA myocardial infarction (MI) register during 1983-1992. All CHD deaths from routine mortality statistics (International Classification of Diseases codes 410-414) were registered in the MI register. Of the CHD deaths in routine mortality statistics 1.7% in men and 4.8% in women did not fulfill the MONICA criteria for CHD death (P<0.001 for the difference between the sexes). In men 4.7% and in women 7.3% (P=0.004) of the deaths registered in the MI Register and classified as CHD deaths by MONICA criteria had another underlying cause of death than CHD in routine mortality statistics; this proportion increased over time in both sexes (P=0.002 in men and P=0.77 in women). The CHD mortality trends obtained separately from the routine mortality statistics and from the FINMONICA MI Register were very similar. In conclusion, the high CHD mortality in Finland reported by the routine mortality statistics is real. It is possible that some CHD deaths have escaped registration, but the decline seen in the CHD mortality is also real.

Adult↗