Search PubMed⌕ Search

Biomedical subjects

S Punsar

Publications and source records attributed to S Punsar.

At least 37 records · Page 2Linked to original sources

Determinants and predictors of heavy alcohol consumption among aging Finnish men.

The aim was to identify socioeconomic, health behaviour, and health factors associated with or predicting heavy alcohol consumption in late middle age (55-74 years) or in old age (65-84 years). The material included a follow-up study of two cohorts of Finnish males resident either in eastern or south-western Finland. The main variables associated with heavy alcohol consumption in late middle age were: relatively young age and heavy smoking. The main associated variables in old age were good mental and physical capacity, occurrence of chronic bronchitis, the absence of certain cardiac diseases, and heavy smoking. Heavy smoking was the main predictor of heavy alcohol consumption 5-25 years later; alcohol consumption 10 years earlier was also an important predictor. Some regional differences were found in associated or predictive variables. The results suggest that, with the exception of alcohol consumption itself and heavy smoking, socioeconomic, health and other health behaviour factors are not very important in explaining or predicting heavy alcohol consumption among aging Finnish men. Drinking and smoking habits were closely related in these aging or aged men.

Age Factors↗

Serum selenium and risk of cancer. A prospective follow-up of nine years.

The association between serum selenium concentration and the risk of cancer was studied in 1110 men aged 55 to 74 years in two rural areas of Finland. The men were followed-up prospectively for 9 years and there were 109 new cases of cancer, with the cases of the first follow-up year excluded. The serum selenium concentrations were adjusted for age, area, smoking, serum cholesterol, and alcohol intake. The patients had a slightly lower adjusted mean serum selenium than the subjects without cancer at the end of the follow-up (+/- standard error of mean) 53.9 +/- 1.5 and 55.3 +/- 0.5 micrograms/l, respectively. The relative risks of cancer were essentially the same when these were calculated in the tertiles of the serum selenium distribution. Thirty-seven men had a history of cancer at baseline or had cancer diagnosed during the first follow-up year and their adjusted mean serum selenium was 49.4 +/- 2.6 micrograms/l, which was significantly lower (P less than 0.05) than that of the subjects without cancer during the follow-up.

Aged↗

Reduction of premature mortality by high physical activity: a 20-year follow-up of middle-aged Finnish men.

The association of physical activity level with the risk of death was analysed for a cohort of 636 healthy Finnish men aged 45-64 years followed up for 20 years. 39% of the cohort were classed as highly active physically at baseline in 1964. Up to 1984 there were 287 deaths, 106 of them due to coronary heart disease (CHD). During the first-two thirds of the follow-up, men with high physical activity had a lower risk of death than did men with low physical activity. During the last third, the survival curves of the men with high and low physical activity gradually converged. Of the men who died, those with high physical activity lived 2.1 years longer (p = 0.002) than those with low physical activity, after adjustment for age, smoking, blood pressure, serum cholesterol, and body mass index. This difference was due mainly to fewer CHD deaths among the highly active group. Low physical activity was clearly weaker than smoking as a predictor of risk of death. High physical activity may thus independently prevent premature death among middle-aged men, but it probably does not prolong the maximum achievable life-span.

Adult↗

Age and regional differences in reliability and factor structure of the Zung Self-rating Scale in elderly Finnish men.

Regional and age differences in the reliability and factor structure of the SDS among elderly (65-84 years) men who were living either in eastern or in southwestern Finland were investigated. The Cronbach alpha coefficient was .803 for the eastern and .809 for the southwestern cohort; these figures were reasonably high. The tendency found was for the coefficient to be somewhat higher for the old (75-84 years) than for the young-old (65-74 years) population. In investigating the factor structure, a principal components factor analysis was performed, and the remaining factors were rotated using the orthogonal Varimax rotation algorithm. Three factors emerged for young-old men in the East, for young-old men in the Southwest and for old men in the Southwest, and four factors for old men in the East. The factor patterns of the first two factors showed similarities in both regions, but their order was different. "Loss of self-esteem" accounted for more of the common variance in the East and "agitated mood" in the Southwest. The differences in the third factor between the two regions were evident.

Aged↗

Prevalence of diabetes mellitus in elderly men aged 65 to 84 years in eastern and western Finland.

We studied the prevalence of diabetes mellitus in men aged 65 to 84 years in Finland. The study sample consisted of 763 men, the survivors of the Finnish cohort of the "Seven Countries Study" first examined in 1959. The participation rate in the present survey was 94%. Blood glucose, fasting and 2 h after a 75-g oral glucose load, was determined from capillary blood. Current WHO criteria for diabetes mellitus were used. The mean fasting blood glucose level, adjusted for age and body mass index, was higher in east than west Finland. It rose with age in both areas. The prevalence of diabetes was 38% in the east and 36% in west Finland. About one-third of the men had impaired glucose tolerance. In the age group 75 to 79 years, the prevalence of diabetes was 65% in the east and 50% in the west. No systematic variation in the prevalence of impaired glucose tolerance with age was found. The mean levels of body mass index decreased with age in the same way in men with diabetes, impaired glucose tolerance and normal glucose tolerance. Body mass index was not higher in men with diabetes or impaired glucose tolerance than in men with normal glucose tolerance.

Aged↗

Levels of some biological risk indicators among elderly men in Finland.

A 25-year follow-up survey of the Finnish men examined in the Seven Countries Study and now 65-84 years old was carried out in the East and the South-West of Finland in 1984. The follow-up examinations were carried out as in the previous surveys. Systolic and diastolic blood pressures were now significantly lower in the East than in the South-West of Finland. Serum total cholesterol and HDL-cholesterol were on the same level in both areas. The East/South-West difference in serum cholesterol, observed in previous studies, had levelled off and that in the blood pressure level had even reversed among the study cohorts. The mean fasting serum glucose was higher in the East than in the South-West of Finland. The mean serum calcium level was the same in both areas.

Aged↗

Thyroid function tests in elderly Finnish men.

Serum total thyroxine (T4), triiodothyronine (T3) and thyrotrophin (TSH) levels were determined among 65-84-year-old Finnish men living either in eastern Finland (n = 309) or in southwestern Finland (n = 389). The mean value for serum total T4 was 112.2 +/- 23.0 nmol/l in eastern Finland and 111.3 +/- 21.9 nmol/l in southwestern Finland. The mean value for serum T3 was 1.76 +/- 0.30 nmol/l in eastern Finland and 1.75 +/- 0.46 nmol/l in southwestern Finland. Serum TSH values showed the mean for men from eastern Finland to be 3.25 +/- 2.29 mU/l and the mean for men from southwestern Finland to be 3.11 +/- 1.83 mU/l. No differences were found in the means of the thyroid function tests between the two areas. Serum T4 levels were not related to age. Serum T3 values fell with age. In both areas, serum TSH levels were highest among men 70-74 years of age.

Age Factors↗

Prevalence of depressive and other symptoms in elderly Finnish men.

The prevalence of depressive and other symptoms were studied in Finnish men aged 65 to 84 years and living either in eastern (n = 310) or in southwestern (n = 378) Finland. The Zung self-rating depression scale showed depressed affect, fatigue and suicidal thoughts to be more common in the east, but indecisiveness to be more prevalent in the south-west. The mean of the sum scores in the Zung scale was 37.8 (+/- 8.4) for the eastern and 37.2 (+/- 8.3) for the south-western population, and no differences were found between the areas in this respect. However, many of the other symptoms, including somatic and psychosomatic (such as pains, dyspnea, nausea, impaired memory, apathy, itching skin and sight disturbances) were more common among men living in eastern Finland. The former findings support the idea that there are differences in the affects between men living in the east and men living in the south-west, but, as a whole, depressive symptoms are equally prevalent in both elderly male populations. The latter finding may reflect the well-known differences in the prevalences of somatic diseases between these two areas.

Affective Symptoms↗

Socio-economic conditions in childhood and mortality and morbidity caused by coronary heart disease in adulthood in rural Finland.

In this study, the hypothesis that bad socio-economic conditions in childhood may increase the probability of coronary heart disease in adulthood is examined. The study is based partly on the data of the East-West Study in Finland, which is part of the Seven Countries Study. The study began with 823 men in Eastern Finland and 888 men in Western Finland in 1959. The mortality and morbidity of the cohorts were followed from 1959 to 1974. Risk factors were measured in medical examinations in 1959, 1964, 1969 and 1974. Parents of those included in the sample were traced by using parish registers from 1900 to 1919. Over 90% of those in the East-West Study were found. The parents' socio-economic position (socio-economic conditions in childhood) was determined. According to our findings, the relative risks of coronary death, myocardial infarction and ischemic heart disease are systematically increased for those born landless in East Finland. Variables partly explaining the increased risk were body height and smoking. The effect of cholesterol was negligible.

Adult↗

Serum cholesterol and cancer mortality in the Seven Countries Study.

In the Seven Countries Study, carried out in Finland, Greece, Italy, Japan, The Netherlands, the United States, and Yugoslavia, among 11,325 "healthy" men aged 40-59 years in 15 years, there were 594 cancer deaths. Among 477 cancer deaths five years after cholesterol measurement, there was a significant excess of lung cancer deaths in the bottom 20% of the cholesterol distributions in the populations. Age, blood pressure, smoking habits, occupation, and relative body weight did not help explain this. A U-shaped relationship between cancer and cholesterol was not seen in any population. Trend analysis with various cutting points indicated increasing risk of lung cancer death at cholesterol levels under 170 mg/dl. The 45 men dead from cancer in the first two years had lower cholesterol levels than their compatriots who died from cancer later but they did not differ in relative weight or fatness. In contrast to relationships for individuals within populations, the highest cancer death rates were in northern Europe, where the general level of cholesterol was also highest. Other characteristics of the populations--age, relative weight, smoking habits, blood pressure, physical activity, and vitamin A and ascorbic acid in the diet--did not help in the attempt to understand the regional differences in cancer mortality. There is no evidence that any of the observed cancer-serum cholesterol relationships among or within the populations involve an effect of serum cholesterol concentration on oncogenesis or cancer mortality but the possibility of such an effect cannot be denied.

Adult↗

Serum selenium and the risk of coronary heart disease and stroke.

The association between serum selenium concentration and five-year risk of cardiovascular disease was studied in 1,110 men aged 55 to 74 years in two rural areas of Finland. In the total cohort, all-cause and cardiovascular deaths were associated significantly with serum selenium of less than 45 micrograms/liter, an adjusted relative risk of 1.4 (95% confidence interval (Cl), 1.0-2.0, p less than 0.05) and 1.6 (95% Cl, 1.1-2.3, p less than 0.05), respectively. Among men free of coronary heart disease at the outset, these associations were of similar magnitude but did not attain statistical significance. Among men free of stroke at the outset, low serum selenium was associated significantly with stroke mortality, an adjusted relative risk of 3.7 (95% Cl, 1.0-13.1). The associations of coronary deaths and myocardial infarctions with low serum selenium were nonsignificant.

Aged↗

HDL serum cholesterol and 24-year mortality of men in Finland.

Examinations of 'healthy' men in Helsinki and in rural west and east Finland in 1956 included estimation of total cholesterol and that in the HDL and beta fractions separated by electrophoresis. Vital status to the end of 1980 has been ascertained for all but eight of the 526 men aged 35-61 and for all but two of 261 men aged 30-34 at entry. Among the men aged 35-61, in 24 years 155 died, 63 from coronary heart disease; among the men aged 30-34, 36 died, 16 from coronary heart disease. All causes and coronary death rates were highest in east Finland where HDL cholesterol was also highest. Coronary death rates were not related to HDL cholesterol in east or west Finland but 16 men dead from coronary heart disease in Helsinki tended to have low HDL values. Consideration of five other entry characteristics did not change the picture with regard to HDL-mortality relationships. Solution of the multiple logistic equation using all those variables found the probability of 24-year coronary death was not significantly related to HDL but was significantly related, positively, to the non-HDL cholesterol concentration. HDL and total cholesterol mean values for men of the same age in the same area of Finland, with lipoprotein separation by the new recommended methods, agree closely with the means recorded in 1956. These 24-year findings are not necessarily in conflict with reports in the literature on an inverse relationship between coronary heart disease incidence and HDL cholesterol based on much shorter periods of follow-up and few data on mortality.

Adult↗

Thyroid autoimmunity and cardiovascular diseases.

The relationship of thyroid autoantibodies and elevated TSH level to indices of cardiovascular diseases was studied in two population series monitored for 5 years and in a cross-sectional hospital series. In a cohort of 1105 males, initially 55-74 years of age, deaths due to cardiovascular causes occurred in 19% of subjects with thyroid autoantibodies and in 11% of controls matched for age (P less than 0.05). In another cohort of 1045 males and 1223 females, initially 40-64 years of age, no difference emerged in males, while 6 out of 20 females who died of cardiovascular causes had thyroid autoantibodies, compared with 18% in the whole series. In a series of 97 hospital patients with myocardial infarction, 7 patients had thyroid autoantibodies as opposed to 12 antibody-positive subjects among controls matched for age and sex. Elevated TSH level appeared to be no better an indicator of cardiovascular morbidity or mortality than thyroid autoantibodies. It is concluded that thyroid autoimmunity may act as a cardiovascular risk factor under certain circumstances, but it does not have any general significance and the mechanism of action remains unclear.

Adult↗

Risk of myocardial infarction in Finnish men in relation to fluoride, magnesium and calcium concentration in drinking water.

To study the influence of drinking water composition on the risk of myocardial infarction, the following study was conducted: The cases (C), men 30-64 years of age, had been discharged with a first acute myocardial infarction (AMI) from Kotka Central Hospital. The hospital controls (HC), matched for age and type of community, were selected for each case among surgical patients. Population controls (PC), matched for age and municipality, were drawn for each case from the population register. Subjects submitted a sample of their drinking water and a filled-in questionnaire. After exclusions, a series of 50 C-HC and 50 C-PC pairs was finally constructed. The point estimate of relative risk (RR) for the association between low F (less than or equal to 0.1 ppm) and increased risk of AMI was 3.0 in the C-HC series. In the C-PC comparison, RR was 4.4 RR for low Mg (less than or equal to 1.2 ppm) was 2.0 in the C-HC comparison and 4.7 in the C-PC comparison. The results are consistent with the hypothesis that both a low F and a low Mg intake are conducive to atherosclerosis leading to AMI.

Adult↗

The Social Insurance Institution's coronary heart disease study. Baseline data and 5-year mortality experience.

The Social Insurance Institution's Coronary Heart Disease Study is a prospective population study designed to investigate the prevalence, risk factors and incidence of coronary heart disease (CHD) in middle-aged Finnish men and women. The study population consisted of 5 738 men and 5 224 women, aged 30-59 years at entry, drawn from 12 cohorts from south-western, western, central and eastern Finland. The cohorts consisted of whole or random samples of rural or semiurban dwellers or employees of a factory. The participation rate was 90 per cent. The prevalence of symptoms was determined by the Rose questionnaire and abnormalities on resting ECG were coded according to the Minnesota code. Blood pressure, smoking habits, serum cholesterol, triglycerides, postload plasma glucose and obesity were the risk factors analysed at the baseline examination. The mortality of examinees has been followed continuously. This report deals with the main findings at the baseline examination and the mortality follow-up experience in 5 years. The prevalence of typical angina pectoris was 4.4 per cent in men and 5.4 per cent in women. Unequivocal ECG signs of past myocardial infarction were observed in 1.0 per cent of men and 0.3 per cent of women. Other ECG findings suggesting CHD were observed in 9.2 per cent of men and 11.1 per cent of women. The 5-year mortality was 4.3 per cent in men and 0.9 per cent in women. Men with typical chest pain symptoms had a seven-fold risk to die from CHD, compared to men without symptoms. Men with ECG abnormalities compatible with an old infarction had a 19.5-fold and men with other ECG findings suggesting CHD a 7.1-fold risk to die from CHD compared to men without resting ECG abnormalities. Men with ECG findings as the only indicator of CHD had worse survival than men with symptoms as the only indicator of CHD. The value of symptoms and ECG findings as predictors of CHD mortality in women was very low.

Adult↗

Importance of coronary risk factors in the presence or absence of myocardial ischemia.

Smoking history, systolic blood pressure, and serum cholesterol concentration were studied for their value in predicting 5-year coronary mortality in middle-aged and older Finnish men. Total experience consisted of 188 deaths from ischemic heart disease during 20,245 person-years. Initially, the men were divided into 3 groups according to the degree of myocardial ischemia: (1) previous myocardial infarction; (2) ischemic heart disease without infarction; and (3) no myocardial ischemia. The 3 main risk factors were associated, independently of each other and of age, with the relative risk of coronary death similarly in the 3 groups, whereas their absolute impact on mortality was strong among men with ischemic heart disease and even stronger among those with a prior myocardial infarction. For example, the estimated excess coronary mortality attributable to smoking 10 to 19 cigarettes per day was 6.3 deaths per 1,000 person-years in the group with no ischemia, 14.6 in the ischemia group, and 43.1 in the infarction group. The results suggest that secondary prevention of ischemic heart disease may be important. Screening of coronary disease among middle-aged and older men also appears justified.

Aged↗