Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 73 records · Page 4Linked to original sources

PubMed1999

Supermarket sales data: a tool for measuring regional differences in dietary habits.

OBJECTIVE: To assess how well supermarket sales data from a major supermarket chain can reflect on regional differences in dietary behaviour by comparing the sales data with the results provided by the annual health behaviour surveys. DESIGN: Cross-sectional observational study. SETTING: The study was carried out in six Finnish cities situated in different parts of Finland. For the study supermarket sales data of milk, sour milk, fats and oils for 1 month, September 1997, were obtained from eight supermarkets. Proportional sales of different types of dairy products were calculated as well as mean salt and fat per cent and the proportion of saturated fat to total fat. The health behaviour surveys from spring 1995, 1996 and 1997 provided information about dietary habits of the adult population in the cities. The reported use of dairy products was compared with the percentage sales. RESULTS: The proportional sales of dairy products varied between the cities. In Pori in western Finland the sale of milk fat was highest in all food groups. In Oulu, northern Finland, the sale of non-fat milk was high. In the capital region the sale of oil was highest. Regional differences could also be seen in the survey data. The similarity between the two different datasets was high. CONCLUSIONS: The use of supermarket sales data for assessing regional differences in health behaviour is feasible. The challenge will be to get supermarket managers willing to provide sales data on a routine basis for monitoring and research.

Animals↗

PubMed1999

The effect of breakfast cereal on diet and serum cholesterol: a randomized trial in North Karelia, Finland.

OBJECTIVE: To test the hypothesis that a high carbohydrate breakfast with breakfast cereal leads to a meaningful reduction in dietary energy intake from fat, especially from saturated fat, and thus lower serum cholesterol levels. DESIGN: An open randomized controlled cross-over trial. The subjects were randomized into intervention breakfast cereal or usual breakfast (control) groups. SETTING: Free-living subjects aged 29-71 y in Eastern Finland SUBJECTS: 224 enrolled, 209 completed the study. The subjects were recruited from a survey of a random population sample and from other sources, and their serum cholesterol was not lower than 5.0 mmol/l. Recruited persons did not have any chronic disease or very low saturated fat intake. INTERVENTION: The cereal group consumed 80 g (men) or 60 g (women) cereal at breakfast and the control group continued their usual dietary habits for six weeks. After a wash out of six weeks, a cross-over with another six week trial period took place. Measurements (including serum samples and a 3 d food record) took place before and after the two trial periods. RESULTS: The intervention period led to 2.5 en% (energy percent units) reduction in saturated fatty acids intake. The reduction in total fat intake was 5.5 en%. This was compensated for by increased intake of carbohydrates. The reduction in saturated fatty acids intake led to modest (but in group 1 significant) 0.15 mmol/l (2.5%) reduction in total serum cholesterol level. CONCLUSIONS: The trial showed that regular cereal breakfast can lead to reduced intake of total and saturated fatty acids of the daily diet and consequently to reduction in serum cholesterol level.

Adult↗

PubMed1999

Comparing smoking and smoking cessation process in the Republic of Karelia, Russia and North Karelia, Finland.

STUDY OBJECTIVE: The aims of this study were to assess and validate self reported smoking prevalence and to assess smoking cessation related process variables in the Republic of Karelia, Russia and in North Karelia, Finland. DESIGN: Comparative population surveys of random population samples from both areas in spring 1992. The study included a self administered questionnaire, physical measurements and laboratory tests. The validity of self reported smoking prevalence was assessed by serum cotinine analyses. SETTING: The district of Pitkäranta in the Republic of Karelia, Russia and province of North Karelia, Finland. PARTICIPANTS: The study population was a 25 to 64 year old population in both areas. A stratified random sample of 1000 people in Pitkäranta and 2000 people in North Karelia was drawn from the population registers. In Pitkäranta 380 men and 455 women, and in North Karelia 673 men and 803 women, participated in the survey. RESULTS: The self reported prevalence rates of daily smoking in Pitkäranta were 65% among men and 10% among women. In North Karelia the respective rates were 29% and 13%. Women in Pitkäranta greatly underreported their smoking status, which was assessed by comparing the self reported data to the serum cotinine measurements. The smoking prevalence among women in Pitkäranta would rise from 10% to 21% if all participants with high cotinine values would be regarded as smokers. Compared with smokers in North Karelia, a higher percentage of smokers in Pitkäranta expressed their wish to quit and believed that they would succeed. However, on average they had fewer previous smoking cessation attempts than smokers in North Karelia. In addition, the health personnel in North Karelia were more active in advising smokers to quit. CONCLUSIONS: High smoking prevalence among men in Pitkäranta obviously contributes much to the high premature death rate in the Republic of Karelia. There is considerable underreporting of smoking in Pitkäranta, especially among women, which is probably attributable to the cultural unacceptability of female smoking in Russia. The common wish to quit, few previous cessation attempts and much lower rates of ex smokers, together with less smoking cessation counselling from health personnel, need to be considered in tailoring antismoking interventions in the area.

Adult↗

PubMed1999

Development of smoking by birth cohort in the adult population in eastern Finland 1972-97.

OBJECTIVE: To analyse the dynamics of smoking prevalence, initiation, and cessation in relation to sex, age, birth cohort, study year, and educational level. DESIGN: Six independent cross-sectional population surveys repeated every five years between 1972 and 1997. SETTING: The provinces of North Karelia and Kuopio in eastern Finland. SUBJECTS: Independent random samples of 18,088 men and 19,200 women aged 25-64 years. Those comprising the oldest birth cohort were born in 1913-17 and those in the youngest were born in 1968-72. RESULTS: Among men the prevalence of smoking decreased over time, but the cohort effect observed in smoking initiation was obscured by the changes in smoking cessation. Differences between the educational categories were small. Among women the prevalence of smoking increased during the study period. This was mainly caused by the less highly educated, in whom smoking initiation clearly increased in successive birth cohorts, but a more moderate cohort effect was also present among the more highly educated women. CONCLUSIONS: In men decreased initiation and increased cessation contributed to the downward trend in smoking prevalence, whereas among women, changes in smoking were mostly caused by augmented initiation in successive birth cohorts. During the study period educational inequalities in smoking widened, as the less highly educated came increasingly to form the smoking population.

Adult↗

PubMed1999

Quit and Win campaigns as a long-term anti-smoking intervention in North Karelia and other parts of Finland.

OBJECTIVE: To evaluate Quit and Win campaigns repeated in North Karelia and rest of Finland. DESIGN: Repeated comparisons of participation rates, abstinence rates, and other measures between North Karelia and the rest of Finland. SUBJECTS: Adult daily smokers in Finland participating in the Quit and Win contests in 1986-1997. INTERVENTIONS: Quit and Win smoking cessation campaigns targeted at adult daily smokers throughout Finland in 1986, 1989, 1994, 1996, and 1997, including more intensive activities in North Karelia. MAIN OUTCOME MEASURES: Participation rates, self reported six-month abstinence rates, other effectiveness measures (% of smokers who attended, intended, tried, and succeeded in cessation). RESULTS: North Karelia's participation rates were significantly higher in each campaign compared with the rest of Finland. The abstinence rates in North Karelia were also higher, the difference being significant in 1986 and 1994 (p < 0.05). In the target population in 1996 over 75% of smokers in North Karelia, compared with 40% of smokers surveyed elsewhere, reported awareness of the campaign (p < 0.001). Approximately 9% of the smokers in North Karelia and 6% elsewhere intended to participate (p = NS). Over 2% in North Karelia, compared with less than 1% elsewhere, tried to quit (p < 0.001). Among the targeted group, 0.3% of North Karelian smokers were complete abstainers throughout the 12 months of follow up, compared with an average of 0.1% in other areas (p < 0.001). CONCLUSIONS: The Quit and Win campaign is a feasible cessation method in long-term community-wide programmes. Intensified community activities are associated with higher success. In repeat campaigns, high participation and abstinence rates can be maintained.

Adolescent↗

PubMed1999

Is the effect of smoking on the risk for coronary heart disease even stronger than was previously thought?

OBJECTIVE: To assess the extent to which smoking cessation among cohort members during the follow-up affects the estimated association between smoking and coronary heart disease (CHD) risk in an observational study with a single determination of the smoking status at baseline. DESIGN: Cross-sectional trend and prospective cohort analyses. SETTINGS: North Karelia and Kuopio provinces in eastern Finland. SUBJECTS: Men (n = 13542) aged 30-59 years who participated in risk factor surveys between 1972 and 1992. Of these, 3937 men belonged to the 1972 cohort with the prospective follow-up. MAIN OUTCOME MEASUREMENTS: Smoking prevalence, CHD mortality, non-CHD mortality, and total mortality. RESULTS: Smoking prevalence in the population decreased from 53% to 37% between 1972 and 1992. In the follow-up of the 1972 study cohort, the association between baseline smoking status and CHD weakened markedly when the follow-up time from the baseline measurement was extended. The risk ratio of cumulative CHD mortality associated with smoking was 6.96 in the first 2-year follow-up and it decreased gradually to 2.06 at the 20-year follow-up. A similar decrease in the risk ratio was observed when the analysis was performed during periods of the follow-up. The association between smoking and non-CHD mortality weakened only slightly when the follow-up time became longer. CONCLUSION: The results from prospective observational studies conducted in populations with a decreasing smoking prevalence may be biased by the misclassification of study subjects during the follow-up as a result of smoking cessation. This results in an underestimation of the risk of CHD caused by smoking. Thus, smoking may be even more harmful for health than the estimates from prospective studies suggest.

Adult↗

PubMed1999

Serum sterols during stanol ester feeding in a mildly hypercholesterolemic population.

We investigated the changes of cholesterol and non-cholesterol sterol metabolism during plant stanol ester margarine feeding in 153 hypercholesterolemic subjects. Rapeseed oil (canola oil) margarine without (n = 51) and with (n = 102) stanol (2 or 3 g/day) ester was used for 1 year. Serum sterols were analyzed with gas-liquid chromatography. The latter showed a small increase in sitostanol peak during stanol ester margarine eating. Cholestanol, campesterol, and sitosterol proportions to cholesterol were significantly reduced by 5-39% (P < 0.05 or less for all) by stanol esters; the higher their baseline proportions the higher were their reductions. The precursor sterol proportions were significantly increased by 10- 46%, and their high baseline levels predicted low reduction of serum cholesterol. The decrease of the scheduled stanol dose from 3 to 2 g/day after 6-month feeding increased serum cholesterol by 5% (P < 0. 001) and serum plant sterol proportions by 8-13% (P < 0.001), but had no consistent effect on precursor sterols. In twelve subjects, the 12-month level of LDL cholesterol exceeded that of baseline; the non-cholesterol sterol proportions suggested that stimulated synthesis with relatively weak absorption inhibition contributed to the non-responsiveness of these subjects. In conclusion, plant stanol ester feeding lowers serum cholesterol in about 88% of subjects, decreases the non-cholesterol sterols that reflect cholesterol absorption, increases the sterols that reflect cholesterol synthesis, but also slightly increases serum plant stanols. Low synthesis and high absorption efficiency of cholesterol results in the greatest benefit from stanol ester consumption.

Anticholesteremic Agents↗

PubMed1998

Trends of back pain in eastern Finland, 1972-1992, in relation to socioeconomic status and behavioral risk factors.

The aim of this study was to compare the trends in the prevalence of back pain between several population subgroups and to assess the stability of the associations between back pain and its potential risk factors. Five cross-sectional surveys with independent random samples were conducted in two provinces in eastern Finland every fifth year from 1972 to 1992. There were 29,043 respondents aged 30-59 years. The respondents completed a questionnaire that asked about the occurrence of back pain during the preceding month. The prevalence of back pain varied between 46 and 50 percent among men and between 46 and 51 percent among women. In general, the trend for the entire sample was fairly stable, but the prevalence rates seemed to differ considerably between subgroups of the population. Back pain was more prevalent among those with lower education and income, those with blue-collar occupations, and those doing heavy work. The trends were significantly inconsistent (p < 0.05), for example, between the categories according to household income and, among men, between the categories according to body mass index, a suspected risk factor for back pain.

Adult↗

PubMed1998

Serum cholesterol distribution and coronary heart disease risk: observations and predictions among middle-aged population in eastern Finland.

BACKGROUND: The purpose of the present study was to assess the implications of cholesterol distribution and its change on coronary heart disease (CHD) mortality and disease prevention at a population level. METHODS AND RESULTS: In five independent risk factor surveys (1972, 1977, 1982, 1987, and 1992) in eastern Finland, serum cholesterol was measured in 27721 randomly selected men and women aged 30 to 59 years. The association between cholesterol level and CHD risk and the prediction of the effect of different prevention strategies was estimated by use of logistic regression models. The entire cholesterol distribution of the population shifted markedly toward lower levels between 1972 and 1992. The proportion of subjects with a very high cholesterol level (> or =8.0 mmol/L), also decreased markedly, from 16% to 3%. The risk of CHD death among subjects with cholesterol > or =8.0 mmol/L was approximately 5-fold that of those individuals having cholesterol <5.0 mmol/L. Nevertheless, because CHD risk increases continuously as serum cholesterol increases, and because the number of people having only slightly or moderately increased serum cholesterol was large, most CHD deaths occurred among them. A 10% reduction in cholesterol levels in the entire population would subsequently reduce CHD mortality by 20%, as much as an effective treatment as a 25% decrease in serum cholesterol among all subjects with cholesterol >6.5 mmol/L and four times more than similar treatment of all subjects with cholesterol > or =8.0 mmol/L. CONCLUSIONS: The community-based population strategy in cardiovascular disease prevention was effective in decreasing cholesterol levels among the entire population, including the subjects with the highest cholesterol values. The balanced application of both high-risk and population strategies is needed for the effective prevention of CHD.

Adult↗

PubMed1998

Socioeconomic variation in back and joint pain in Finland.

UNLABELLED: Differences in the prevalence of back and joint pain by occupational class and education were studied in surveys representative of adult Finns. The effects of lifestyle factors and mental distress on these differences were also analysed. The material comprised 3915 women and 3629 men, all occupationally active. Occupational class and level of education were associated with back and joint pain; the associations were more obvious in men than in women. Among men, the age-adjusted odds ratio of joint pain in farmers was 3.2 (95% CI: 2.1-5.0), in manual workers 2.6 (1.9-3.6), in entrepreneurs 2.4 (1.5-3.7) and in lower white-collar workers 1.7 (1.1-2.4) as compared with upper white-collar employees. Similar odds ratios of back pain were 2.1 (1.6-2.9) in farmers, 1.8 (1.5-2.3) in manual workers, 1.7 (1.2-2.4) in entrepreneurs and 1.4 (1.1-1.7) in lower white-collar workers. Most of the associations persisted in multivariate analyses, in which height, marital status, lifestyle (smoking, leisure-time physical activity and body mass index (BMI)) and mental distress were considered; in these models, mental distress was consistently associated with pain. Back pain was associated with smoking in men and with BMI in women; BMI was also associated with joint pain in both sexes. In women, height showed an association with back pain for which a doctor had been consulted. Marital status, alcohol consumption, leisure-time physical activity and the urbanization level of the community were not important as determinants of pain. CONCLUSION: Obvious differences occurred in back and joint pain by indicators of social class that were not due to socioeconomic differences in lifestyle, height or mental distress.

Adult↗

PubMed1998

Sales data of a supermarket--a tool for monitoring nutrition interventions.

OBJECTIVE: The aim of the study was to examine the daily variations in sales data for individual food items in a supermarket and to assess the usefulness of the computerized sales data of supermarkets for reliable monitoring and evaluation of shopping behaviour. DESIGN: Longitudinal observational study. SETTING: The study was carried out in one supermarket in Mikkeli, Finland. Seventy-nine packed food items from food groups important for salt and fat intake were monitored. In all food groups both 'healthier' and 'reference' products were included for assessment of both direct sales and proportional sales. The sales data were collected daily for 2 months in May and September 1996 by reading the European Article Numbering (EAN) codes of the packed foods. RESULTS: The proportional sales turned out to be a more stable and useful measure than the direct sales data and the variation remained the same when the monitoring time was increased from 1 week to 1 month. CONCLUSION: Proportional sales data are proposed as a tool for measuring the effect of nutrition interventions and also as a possible indirect assessment for population salt and fat intake.

Dietary Fats↗

PubMed1998

Long-term cost and life-expectancy consequences of hypertension.

OBJECTIVE: To estimate hypertension's long-term cost and impact on life expectancy. DESIGN: A 19-year individual follow-up study. Subjects were categorized according to their baseline (1972) diastolic blood pressure (DBP) level into three groups: normotensive (DBP < 95 mmHg), mildly hypertensive (DBP 95-104 mmHg), and severely hypertensive (DBP > 104 mmHg). By using their social security identification numbers, we linked the subjects to a set of national registers covering hospital admissions, use of major drugs, absence due to sickness, disability pensions, and deaths. SUBJECTS: A random population sample of 10 284 men and women aged 25-59 years from the provinces of Kuopio and North Karelia in eastern Finland. MAIN OUTCOME MEASURES: The numbers of years of life and years of work lost, the cost of drugs and hospitalization, and the value of productivity lost due to disability and premature mortality. RESULTS: The difference in life expectancy between normotensive and severely hypertensive men was 2.7 years, of which 2.0 years was due to cardiovascular disease (CVD). Among women the corresponding differences were 2.0 and 1.5 years. Severely hypertensive men lost 2.6 years of work more than did normotensive men, of which 1.7 years was due to CVD. Among women the differences were 2.2 and 1.3 years. The mean undiscounted total costs (USA dollars at 1992 prices) were $132 500 among normotensive, $146 500 among mildly hypertensive, and $219 300 among severely hypertensive men, of which CVD accounted for 28, 39, and 43%, respectively. More than 90% of the total costs were indirect productivity losses. Among women the total costs were lower for all DBP categories, as were the shares of CVD-related costs. The proportional increase in costs on going from the lowest to the highest DBP category was, however, somewhat larger among women. CONCLUSIONS: On the population level, severe hypertension leads to considerable losses in terms of years of life lost, years of work lost, and costs. However, the overall impact of mild hypertension is much more limited.

Adult↗

PubMed1998

Low diastolic blood pressure and mortality in a population-based cohort of 16913 hypertensive patients in North Karelia, Finland.

OBJECTIVE: To examine the relationship between mortality and diastolic blood pressure during treatment. DESIGN: A prospective follow-up of a population-based dynamic cohort of hypertensive patients. SETTING: Province of North Karelia, eastern Finland. PATIENTS: A cohort of 16 913 North Karelian hypertensive patients in hypertension register of the North Karelia Project, who had been followed up since 1972 until the end of 1985. Most of these patients had been under antihypertensive drug therapy during the follow-up. MAIN OUTCOME MEASURES: Death: all deaths (n = 4490), deaths from cardiovascular disease (n = 2995) and deaths from non-cardiovascular disease (n = 1495). RESULTS: Of all deaths, 17% of those among men and 24% of those among women were of patients with mean diastolic blood pressures less than 90 mmHg. We found a U-shaped relationship between diastolic blood pressure and total, cardiovascular and non-cardiovascular mortalities. We investigated this relationship in more detail using Cox regression model. Low diastolic blood pressure was associated independently with increased mortality for the patients aged 50 years or more at baseline. The occurrence of cardiac failure and other cardiovascular complications of hypertension were more important determinants of mortality than was low diastolic blood pressure alone. CONCLUSIONS: We demonstrated that there is an association between low diastolic blood pressure and mortality for treated hypertensive patients aged 50-69 years. The clinical importance of this relationship for patients without any cardiovascular complications of hypertension seems negligible. For patients with complications, these complications are likely to be primary factors causing greater than normal mortality and low diastolic blood pressure is mostly a secondary phenomenon. Our data do not lend support to speculations that there is overtreatment of hypertension, which would increase mortality through making diastolic blood pressures too low.

Aged↗

PubMed1998

Do changes in cardiovascular risk factors explain the increasing socioeconomic difference in mortality from ischaemic heart disease in Finland?

STUDY OBJECTIVE: To estimate the extent to which changes in blood pressure, smoking, and serum cholesterol concentration explain the observed increase in socioeconomic differences in mortality from ischaemic heart disease (IHD) in Finland during the past 20 years. DESIGN: Predicted changes in mortality from IHD were calculated using logistic regression models with the risk factor levels assessed by cross sectional population surveys conducted in 1972, 1977, 1982, and 1987. The subjects included white collar and blue collar workers and farmers. The predicted changes were compared with the observed mortality changes in the same socioeconomic groups in the total population of the same geographical area. SETTING: North Karelia and Kuopio provinces, eastern Finland. PARTICIPANTS: 16,741 men and 16,389 women aged 30-59 randomly drawn from the population registers of the study areas. Mortality data were obtained from the total population in the same areas. MAIN RESULTS: In men, the changes in diastolic blood pressure, total serum cholesterol, and smoking predicted a 28% decline in the mortality from IHD among white collar workers, a 30% decline among blue collar workers, and a 33% decline in farmers. Observed declines in the same socioeconomic groups were 61%, 40%, and 37%, respectively. In women, the predicted decline was 41% among white collar workers, 35% among blue collar workers, and 39% among farmers. The respective observed declines were 57%, 43%, and 20%. CONCLUSIONS: Less than half of the decline in IHD mortality among white collar men was explained by the risk factor changes, while they explained 75% of the decline among blue collar men and 89% of the decline among male farmers. Changes in risk factors did not explain the increasing difference in IHD mortality between the socioeconomic groups, especially among men.

Adult↗

PubMed1998

Fifteen-year follow-up of smoking prevention effects in the North Karelia youth project.

OBJECTIVES: This study evaluated the long-term effects of a school- and community-based smoking prevention program in Finland. METHODS: Four intervention schools from North Karelia and two control schools from another province were chosen for the evaluation. Students who received the intervention were taught to resist social pressures to smoke. The program began in 1978 with seventh-grade students and ran through 1980, with a 15-year follow-up. In North Karelia, a community-based smoking cessation program for adults was also carried out. RESULTS: Mean lifetime cigarette consumption was 22% lower among program subjects than among control subjects. Smoking and prevalence were lower up to the age of 21. CONCLUSIONS: Long-term smoking prevention effects can be achieved if a school-based program using a social influence model is combined with community and mass media interventions.

Adolescent↗

PubMed1998

Role of known risk factors in explaining the difference in the risk of coronary heart disease between eastern and southwestern Finland.

We analysed to what extent cardiovascular risk factors may explain the observed difference in the risk of coronary heart disease (CHD) between two areas with markedly different CHD incidence. The study included 7049 men aged 25-64 years who had participated in a baseline survey in 1982 or in 1987 in the Kuopio and North Karelia provinces of eastern Finland and in the Turku-Loimaa region of southwestern Finland. During the baseline surveys the following factors were determined: smoking, blood pressure, cholesterol, high-density lipoprotein cholesterol, diabetes, height, body mass index, family history of CHD and socioeconomic status. The cohorts were followed for coronary events until the end of 1994. CHD risk was about 40% higher in eastern than in southwestern Finland. The levels of most of the measured risk factors were also higher in eastern Finland. Differences in risk factor levels explained about 40% of the excess CHD risk in eastern Finland. The impact of the classical risk factors, such as smoking, cholesterol and blood pressure, on the regional difference was smaller than expected. Single risk factor measurements in our population surveys, however, may not have correctly reflected the long-term exposure of individuals to these risk factors, particularly because the surveys were carried out within a period during which these risk factors were undergoing favourable changes in the Finnish population. In addition to the classical risk factors, regional differences in body height and socioeconomic status were associated with the regional differences in CHD risk.

Adult↗

PubMed1998

Intra- and interindividual variability of hemostatic factors and traditional cardiovascular risk factors in a three-year follow-up.

Elucidation of the key role of thrombosis in cardiovascular disease events has arisen considerable interest in hemostatic factors and in the repeatability of their determinations. Data on long-term repeatability has, however, remained scanty. We examined twice 208 men and 265 women in North Karelia, eastern Finland. The baseline examination was a part of the FINRISK 1992 Hemostasis Study and the age-range of participants was between 45-64 years. The re-examination took place three years later in 1995. Both surveys followed the same protocol and were carried out during the same season. Spearman rank correlation coefficients between 1992 and 1995 measurements of fibrinogen, factor VII coagulant activity (FVII:C), factor VII antigen (FVII:Ag), and plasminogen were among men 0.72, 0.77, 0.46 and 0.56, respectively. For total cholesterol, HDL-cholesterol, triglycerides and diastolic blood pressure the corresponding coefficients were 0.74, 0.83, 0.66, and 0.54. In women, the coefficient of fibrinogen was lower than in men, 0.62, otherwise the results were similar. Of men belonging to the highest quarter of fibrinogen, FVII:C, FVII:Ag and plasminogen in 1992, 65%, 60%, 53% and 60% belonged to the highest quarter of respective distributions also in 1995. In women, the corresponding proportions were 64%, 65%, 46% and 58%. The modest repeatability of FVII:Ag and plasminogen was mainly due to the high intraindividual variability. However, in comparisons of plasma levels between two groups, relatively small sample sizes seemed to give adequate statistical power to detect possible differences in FVII:Ag and plasminogen. In conclusion, the long-term repeatability of fibrinogen and FVII:C is similar to that of triglycerides and even better than that of diastolic blood pressure, but somewhat lower than the repeatability of total cholesterol. FVII:Ag and plasminogen did not have very good repeatability and more than one measurement of them should be considered if they are used as predictors of cardiovascular disease in prospective studies.

Cardiovascular Diseases↗

PubMed1998

Changes in premature deaths in Finland: successful long-term prevention of cardiovascular diseases.

This article describes the long-term consequences of successful cardiovascular disease (CVD) prevention and its influence on premature mortality in Finland, with special reference to North Karelia. Active community-based CVD prevention began in 1972 in the province of North Karelia (population, 180,000). Since 1977, active preventive work has been carried out nationwide, taking advantage of the experience from North Karelia, which continued as a demonstration area for integrated prevention of noncommunicable diseases. Comprehensive community-based interventions as part of WHO interhealth and CINDI programmes in North Karelia and nationwide aimed at changing the target risk factors and health behaviours (serum cholesterol, blood pressure, smoking, diet) at the population level. Age-adjusted mortality rates for CVD, coronary heart disease (CHD), cerebrovascular disease, all cancers, lung cancer, accidents and violence, and all causes in the population aged 35-64 years from the pre-programme period (1969-71) to 1995 were the main measures of the outcome. Among men there was a great reduction in deaths from CHD, CVD, cancer, and all causes in the whole country. From 1969-71 to 1995 the age-standardized CHD mortality (per 100,000) decreased in North Karelia by 73% (from 672 to 185) and nationwide by 65% (from 465 to 165). The reduction in CVD mortality was of the same magnitude. Among men, CHD mortality decreased in the 1970s, as did lung cancer mortality in the 1980s and 1990s, significantly more in North Karelia than in all of Finland. Among women there was a great reduction in CVD (including CHD and stroke) mortality and all-causes mortality, but only a small reduction in cancer mortality. These results show that a major reduction in CVD mortality among the working-age population can take place in association with active reduction of major risk factors, with a favourable impact on cancer and all-causes mortality.

Adult↗