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Biomedical subjects

P Puska

Publications and source records attributed to P Puska.

At least 145 records · Page 8Linked to original sources
PubMed1991

The North Karelia Youth Programs.

Two family-based and two community- and school-based studies have been done in the province of North Karelia in eastern Finland. In the two family-based studies it was possible to decrease serum cholesterol level among children by 15%, showing that to a great extent the extremely high blood cholesterol level among Finnish children can be explained mainly by the typical Finnish diet high in saturated fat. In the first North Karelia Youth Project it was possible to affect the onset of smoking among adolescents. Two years after the program, smoking was about 30% less common in the intervention school than in the reference schools. In the eighth-year follow up survey the effect of the teacher-delivered program was still seen. In the second North Karelia Youth Project it was possible to delay the onset of smoking during the seventh grade but no permanent effect was seen. Diet was changed more among the program school students than in the reference school. These studies, done during the last 10 years, show the cardiovascular risk factors can be reduced among children and adolescents. The next main question is how to use these findings in the normal school and health care system. We have started the National Healthy School Program in Finland to assess the extent to which these programs can be implemented on the national level.

Adolescent↗
PubMed1991

Depression late after combat: a follow-up of Finnish World War Two veterans from the seven countries east-west cohort.

An analysis from the Finnish East and West Cohort of the Seven Countries Study tested the hypothesis that front line service during modern warfare is associated with depression later in life. World War Two-era Finnish combat veterans were compared to Finnish veterans who were non-combatants. Both groups were followed from 1959 to 1984. Dependent variables were the Zung depression scale and other measures of psychosocial adaptation and mental health. Analysis of variance of Zung scores by combat exposure was close to statistical significance (p = 0.0501). Even if statistical significance had been reached, it is felt that the absolute magnitude of the differences between the populations appear quite trivial. A significant association was found for those who had participated in over nine battles and when grouping depression, sleeplessness, paranoia, hallucinations, schizophrenia, and other mental illness into the general category of any mental illness (O.R. = 4.414; 95% C.I. = 1.113, 17.503). This seems to support the residual stress hypothesis pertaining to modern combat exposure.

Adult↗
PubMed1990

Predictors of high functional capacity and mortality in elderly Finnish men.

Factors predicting high functional capacity in old age and 25-year mortality were studied in 1711 men aged 40 to 59 years. The study population was that of the East-West Study, i.e. the Finnish part of the Seven Countries Study. After the 25-year follow-up (in 1984) 766 men were still alive. Nonsmoking and good pulmonary function in earlier middle-age and the absence of coronary heart disease, cerebrovascular disease or emphysema in later middle-age predicted high functional capacity in old age. High systolic blood pressure, low forced vital capacity, smoking, and the presence of coronary heart disease predicted mortality in the next 10 to 25 years. Although mortality rates were higher in eastern Finland, the predictors were similar in both the eastern and the southwestern parts of the country.

Aged↗
PubMed1990

Serum cholesterol distribution, measurement frequency and cholesterol awareness in three geographical areas of Finland.

The serum cholesterol distribution in three geographical areas of Finland was examined during the first and the second FINMONICA surveys in 1982 and 1987. The mean serum cholesterol concentration changed very little during this observation period. In 1987 the population mean (+/- SD) was 6.12 +/- 1.26 mmoll-1 in men aged 25-64 years and 5.96 +/- 1.28 mmoll-1 in women. Only approximately 20% of the Finns had their serum cholesterol at the level which is regarded as desirable by recent international recommendations. The frequency of cholesterol measurements increased in Finland, especially in North Karelia, from 1972 to 1977 but since then no further increase has taken place. From 1982 to 1987 the proportion of subjects whose cholesterol level was over 6.5 mmoll-1 and who reported knowing that their cholesterol was high increased from 27% to 31% in men and from 24% to 34% in women, respectively. It is concluded that approximately 45% of the adult Finnish population is at moderately increased risk and further 33% at considerably increased risk of coronary heart disease because of the elevated serum cholesterol.

Adult↗
PubMed1990

Eight-year follow-up results of an adolescent smoking prevention program: the North Karelia Youth Project.

In the North Karelia Youth Program five to 10 classroom sessions over two years taught skills to resist pressures to start smoking to 13 to 15 year old students. Compared to students from comparison schools, the treatment groups reported less smoking immediately after the intervention and in a four-year follow-up survey. At the eight-year follow-up, there was consistent evidence of possible preventive effects only among those who had been non-smokers when the program began.

Adolescent↗
PubMed1990

Dietary fat and blood pressure in humans.

The regulation of blood pressure by dietary means represents an important approach toward the reduction of morbidity and mortality of heart disease. The results of our dietary intervention studies demonstrated that a lowered saturated fat, higher polyunsaturated fat diet had a lowering effect on both systolic and diastolic blood pressure, and a lowering effect on blood lipids. These beneficial effects were accomplished without drastic changes in the typical Western diet. The amount of meat, dairy products, fish and eggs was not altered from the usual intake, while the intake of fruits, vegetables and grains increased. As a consequence of altering the diet, we have found that the blood pressure lowering effect appears to be mediated through linoleic acid (n-6). It is evident from these results that the role of diet must be given serious consideration for the control of blood pressure.

Adult↗
PubMed1989

Risk factors and 25 year risk of coronary heart disease in a male population with a high incidence of the disease: the Finnish cohorts of the seven countries study.

OBJECTIVE: To assess the efficacy of high serum cholesterol concentration, raised blood pressure, and smoking as predictors of coronary heart disease. DESIGN: Prospective cohort study of middle aged men conducted over 25 years. SETTING: Finish components of an ongoing international study (seven countries study). PARTICIPANTS: 1520 Men who at age 40-59 in 1959 were free of clinically evident heart disease. INTERVENTIONS: At each follow up visit a detailed medical examination including resting electrocardiography was performed, blood pressure and serum total cholesterol concentration were measured, and smoking was assessed. MEASUREMENTS AND MAIN RESULTS: 825 Deaths (54% of participants) occurred during follow up, of which 335 were due to coronary heart disease. The hazard ratio for death from coronary heart disease with respect to risk factors at entry were: for serum cholesterol concentrations above 8.4 mmol/l v below 5.2 mmol/l, 2.68 (95% confidence interval 1.62 to 4.42); for systolic blood pressure in the highest quintile v that in the lowest quintile, 2.46 (1.72 to 3.50); and for smoking 10 or more cigarettes daily v never smoking, 1.95 (1.36 to 2.79). The hazard ratios with respect to cholesterol concentrations and blood pressure remained constant during follow up but the ratio with respect to smoking diminished, mainly owing to men giving up the habit. The estimated conditional probability of a 50 year old man dying of coronary heart disease in the next 25 years ranged from 12% among those with the most favourable risk factor profile to 75% among those with the least favourable profile. CONCLUSIONS: High risk factor levels (as determined in this study) in middle aged men may greatly increase the absolute probability of death from coronary heart disease when the period of study is relevant to the human life span.

Blood Pressure↗
PubMed1989

Smoking and leanness: evidence for change in Finland.

Many studies have shown smokers to weigh less than non-smokers, which is plausible given the metabolic effects of cigarette smoke. The interrelation between smoking and relative body weight and its change over time were analysed by using data from Finnish population based surveys from 1982 and 1987. Among both men and women the inverse association between smoking and body mass index was clearly weakened between 1982 and 1987. In 1987 among men aged 25-44 smoking was positively related to body mass index. Moreover, the relation between smoking and waist to hip girth ratio was positive in both sexes at all ages. Years of smoking was nevertheless confirmed as a significant inverse predictor of relative weight. A cluster of unfavourable health habits, including high consumption of alcohol and saturated fats, especially emerged among younger smokers. This may have been due to different selection of smokers in Finland, where smoking increasingly seems to be a form of deviant or risk taking behaviour. It is concluded that at a population level the metabolic effects of smoking seem to be increasingly overridden by several other unfavourable health behaviours of smokers.

Adult↗
PubMed1989

Alcohol consumption and mortality in aging or aged Finnish men.

The association between alcohol consumption and 10-year mortality by death cause was studied in 1112 men aged 55-74 years and living either in eastern or south-western Finland. After adjustment for age, blood pressure, smoking, serum cholesterol, and other variables, the relative odds ratio of 10-year total mortality associated with consuming 1-273 g of absolute alcohol per month was 0.9 (95% confidence interval of 0.6-1.2) and with consuming more than 273 g per month due to violence was small, 15, but relative odds of violent death associated with consuming 1-273 and 274 or more grams of alcohol per month were 3.4 and 16.2, respectively (95% confidence intervals of 0.4-31.9 and 1.9-141.2).

Aged↗
PubMed1989

Predictors of disability in elderly Finnish men--a longitudinal study.

Factors predicting disability in late life were studied in 716 men from eastern or southwestern Finland in connection with the 25-year follow-up of the East-West Study, which is part of the Seven Countries Study, in 1984. In middle-aged men, low forced vital capacity, occurrence of diabetes, presence of intermittent claudication, high diastolic blood pressure, higher age and lower educational level showed the greatest predicting power for future disability 15-25 years later. In later middle age, low forced vital capacity, presence of intermittent claudication, cerebrovascular disease or coronary heart disease and higher age were the most powerful predictors for disability 10 years later. In order to lower disability in old age, it is important to prevent deterioration of ventilatory function and cardiovascular diseases in middle-aged populations and to treat chronic diseases adequately.

Aged↗
PubMed1989

Contribution of risk factor changes to the decline in coronary incidence during the North Karelia project: a within-community analysis.

We investigated the contribution of risk factor changes to the decline in incidence of ischaemic heart disease between three five-year periods (1972-76, 1977-81, 1982-86) in a community-based cardiovascular disease (CVD) control programme, the nOrth Karelia project. Random population samples of over 10,000 people were examined in 1972, 1977 and 1982 and followed for five years. Population attributable benefits were estimated for each time period from reductions in excess risk associated with S-cholesterol, tobacco products per day and the mean of systolic and diastolic blood pressure which were entered in logistic models with age and sex. Changes in risk factors accounted in North Karelia for 89% and in the reference population for 20% of the decline in ischaemic heart disease from 1972-6 to 1977-81. In healthy people, risk factor reductions accounted in North Karelia for 100%, but in the reference population only for 23% of the decline. The decline was non-significant in both areas from 1977-81 to 1982-86. In subjects with either CVD or diabetes, there was no decline in North Karelia in either period, whereas 30% and 64% of the decline (ns) in the reference population in the two periods, respectively, was attributable to risk factor changes. These data suggest that although the decline in the incidence of ischaemic heart disease in North Karelia did not differ from that in the reference population it was largely attributable to risk factor reductions in the healthy population. The decline in the reference population appears to be associated with changes in lifestyle, secondary prevention activities and medical care.

Adult↗
PubMed1989

The development of hypertension care in Finland from 1982 to 1987.

The development of hypertension care in Finland was evaluated using the data from two independent population samples of the FINMONICA Project comprising 9350 and 6250 persons examined in 1982 and 1987, respectively. The sampling frame was the population aged 25 to 64 years in the provinces of North Karelia and Kuopio in eastern Finland and in the Turku-Loimaa region in south-western Finland. During the 5-year period, the mean systolic blood pressure levels decreased in all of the groups except the North Karelian men. Mean diastolic blood pressure did not change significantly. The proportion of hypertensive men with adequately controlled blood pressure increased from 22.6 to 29.4% [difference 6.8%, 95% confidence interval (Cl) for the difference 2.4-11.2] during 1982-1987. At the same time, the proportion of hypertensive men unaware of their condition fell from 30 to 20.9% (difference -9.1%, 95% Cl for the difference -13.4- -4.8). There was corresponding falls for women from 39.2 to 41.3% (difference 2.1%, 95% Cl for the difference -3.1-7.3) and from 15.4 to 13.1% (difference -2.3%, 95% Cl for the difference 1.4- -6.0), respectively. Thus, obvious progress had taken place, although the situation remained far from satisfactory. The possibility of overly aggressive treatment of hypertension was also investigated. It was found that only less than 10% of the middle-aged hypertensive men treated with drugs had diastolic pressures less than or equal to 85 mmHg, suggesting that this might not be an issue of concern at community level.

Adult↗
PubMed1989

Changes in body mass index in a Finnish population between 1972 and 1982.

Population-based data on changes in body mass index are scarce. We have examined about 9700 people aged 30-59 years in two provinces of East Finland in 1972, 1977 and 1982. The age adjusted mean value of body mass index (kg m-2) in 1972 was 26.0 +/- 3.4 in men and 26.9 +/- 4.7 in women, increasing with age. During the 10-year follow-up the mean body mass index increased in men to 26.5 +/- 3.6 (P less than 0.001). In women we found a decrease in mean body mass index to 26.4 +/- 4.9 (P less than 0.001). The increase trend in body mass with age remained in women, while in men the age trend increased from survey to survey. The proportion of obese men also increased while in younger women a decrease was observed. The results of this study show the association between changes in physical activity, education etc. and the observed changes in the body mass index.

Adult↗