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Implementation of a hypertension control program in the county of North Karelia, Finland.

https://arctichealth.org/en/permalink/ahliterature244059
Source
Public Health Rep. 1981 Nov-Dec;96(6):503-13
Publication Type
Article
Author
A. Nissinen
J. Tuomilehto
J. Elo
J T Salonen
P. Puska
Source
Public Health Rep. 1981 Nov-Dec;96(6):503-13
Language
English
Publication Type
Article
Keywords
Adult
Evaluation Studies as Topic
Female
Finland
Follow-Up Studies
Goals
Health education
Health Occupations - education
Humans
Hypertension - prevention & control
Male
Mass Screening
Middle Aged
Public health nursing
Registries
Abstract
A hypertension control program was established as part of the more comprehensive North Karelia Project. This project was started in 1972 in response to a petition from the population of North Karelia, a county in Finland, asking for national assistance to reduce the exceptionally high cardiovascular disease mortality and morbidity in the area. The North Karelia Project was carried out from 1972 to 1977.The hypertension control program was implemented mainly in local health centers by physicians and public health nurses, who followed guidelines issued by the project staff and worked under its supervision.Although the target population for the North Karelia Project was the entire population of North Karelia, the project focused on middle-aged men. The hypertension subprogram was introduced in steps. Its objectives included the training of health personnel, establishment of an information system in the county to educate people about hypertension, and organization of the detection, treatment, and followup of hypertensives. A hypertension dispensary was established in each of the 12 health centers in the county. Continuous training of the local public health nurses and physicians faciliated integration of the hypertension program into the operations of the health centers.A central hypertension register and the hypertension control clinics at the health centers were the essential tools in the systematic followup of hypertensives. Some 17,000 hypertensives were on the register by the end of the 5-year project.The main aim in providing health education about hypertension, as well as in treating hypertension itself, was to prevent severe cardiovascular diseases as a whole. Therefore the hypertension control program was integrated into the comprehensive cardiovascular disease control program, and hypertensives received advice concerning smoking and dietary changes as well as about high blood pressure.A survey of health care personnel in North Karelia and in a reference area showed that the care of hypertensives was more systematic in North Karelia and that its health care personnel were more satisfied with the cardiovascular disease care that was provided.
Notes
Cites: Scand J Soc Med. 1976;4(2):67-70959785
Cites: Am J Med. 1972 May;52(5):653-635027555
Cites: Lancet. 1978 Jan 7;1(8054):1-574494
Cites: JAMA. 1976 May 24;235(21):2299-306946622
Cites: WHO Chron. 1973 Feb;27(2):55-84695971
Cites: Lancet. 1980 Oct 25;2(8200):900-46107554
Cites: Br Med J. 1979 Nov 10;2(6199):1173-8519351
Cites: Public Health. 1979 May;93(3):143-52451123
PubMed ID
7302104 View in PubMed
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[10 years of the ischemic heart disease prevention project in northern Karelia].

https://arctichealth.org/en/permalink/ahliterature239026
Source
Cas Lek Cesk. 1985 Mar 29;124(13):385-9
Publication Type
Article
Date
Mar-29-1985

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

https://arctichealth.org/en/permalink/ahliterature246258
Source
Scand J Rehabil Med. 1980;12(1):33-42
Publication Type
Article
Date
1980
Author
J T Salonen
P. Puska
Source
Scand J Rehabil Med. 1980;12(1):33-42
Date
1980
Language
English
Publication Type
Article
Keywords
Adult
Community Health Services - organization & administration
Counseling
Evaluation Studies as Topic
Female
Finland
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - mortality - prevention & control - rehabilitation
Patient Education as Topic
Patient Participation
Physical Education and Training
Risk
Smoking - prevention & control
Abstract
The comprehensive community programme for the control of cardiovascular diseases in North Karelia includes a special subprogramme for the rehabilitation and secondary prevention among patients with an acute myocardial infarction (AMI). The target group of the programme were persons under the age of 65 who had an AMI according to the community-based AMI register and had survived the acute phase of the disease. The programme consisted of systematic long-term medical follow-up at an outpatient MI clinic and of decentralized local group-rehabilitation with special emphasis on secondary prevention. The main component of the programme were health education and submaximal physical exercise, aiming at the reduction of the known secondary risk factors and the improvement of the general well-being of the patients. The feasibility of this programme was good. During the five-year period from 1973 to 1977 a total of 1308 persons under the age of 65 survived an AMI. Out of these patients 515 visited the outpatient MI clinic and 575 took part in the rehabilitation groups. The participation rate in the rehabilitation groups in the whole community increased during the period from 24% to 63%. During the programme period there was a reduction in incidence of recurrent infarctions and new vocational invalidity pensions among the patients with AMI.
PubMed ID
7384764 View in PubMed
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[Relation of mortality, coronary disease mortality and risk factors to the socioeconomic background of middle-aged men].

https://arctichealth.org/en/permalink/ahliterature242302
Source
Duodecim. 1983;99(9):584-92
Publication Type
Article
Date
1983

Socioeconomic status and progression of carotid atherosclerosis. Prospective evidence from the Kuopio Ischemic Heart Disease Risk Factor Study.

https://arctichealth.org/en/permalink/ahliterature209171
Source
Arterioscler Thromb Vasc Biol. 1997 Mar;17(3):513-9
Publication Type
Article
Date
Mar-1997
Author
J. Lynch
G A Kaplan
R. Salonen
J T Salonen
Author Affiliation
Human Population Laboratory, Public Health Institute, Berkeley, Calif 94704, USA. jwlynch@emf.net
Source
Arterioscler Thromb Vasc Biol. 1997 Mar;17(3):513-9
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Adult
Arteriosclerosis - epidemiology - psychology
Carotid Artery Diseases - epidemiology - psychology
Educational Status
Finland - epidemiology
Humans
Income
Male
Middle Aged
Prospective Studies
Risk factors
Abstract
Socioeconomic status (SES) is importantly associated with cardiovascular morbidity and mortality, but no information exists on the relationship between SES and progression of atherosclerotic vascular disease. We investigated the association between education and income and the 4-year progression of carotid atherosclerosis in a population-based sample of Finnish men. Data from the Kuopio Ischemic Heart Disease Risk Factor Study were used to estimate changes in maximum and mean intima-media thickness (IMT) and maximum plaque height across levels of SES in 1022 men. Associations between SES and atherosclerotic progression were examined in relation to risk factors and stratified by baseline levels of atherosclerosis and prevalent ischemic heart disease (IHD). There were significant, inverse, graded relationships between levels of education and income for all three progression measures, which were largely unaffected by risk factor adjustment. For education, the age- and baseline IMT-adjusted maximum progression for those with primary schooling or less was 0.28 mm and for those who graduated from high school, 0.24 mm (P = .05). Compared with the lowest SES group, men with the highest SES had 14% to 29% less atherosclerotic progression, depending on the measure used. Associations of the same magnitude were evident in subgroups without advanced baseline IMT and in men who were free of IHD. These results show that men with poor education and low income have significantly greater progression of carotid atherosclerosis than men with more advantages. The findings strengthen the contention that SES plays a significant role early in the atherosclerotic disease process and that reducing the burden of atherosclerotic vascular disease associated with lower SES will require approaches that focus on all stages of the life course.
PubMed ID
9102170 View in PubMed
Less detail

Socioeconomic status and risk of cancer, cerebral stroke, and death due to coronary heart disease and any disease: a longitudinal study in eastern Finland.

https://arctichealth.org/en/permalink/ahliterature242676
Source
J Epidemiol Community Health. 1982 Dec;36(4):294-7
Publication Type
Article
Date
Dec-1982
Author
J T Salonen
Source
J Epidemiol Community Health. 1982 Dec;36(4):294-7
Date
Dec-1982
Language
English
Publication Type
Article
Keywords
Adult
Cerebrovascular Disorders - mortality
Coronary Disease - mortality
Educational Status
Finland
Humans
Longitudinal Studies
Male
Marriage
Middle Aged
Neoplasms - mortality
Risk
Socioeconomic Factors
Abstract
The association of socioeconomic status with the risk of death from ischaemic heart disease and any disease as well as the risk of cerebral stroke and any cancer was studied in 3644 men aged 30-59, based on a random sample from the population of eastern Finland. Age, smoking, blood pressure, and serum cholesterol concentration were allowed for in multiple logistic models. On the basis of these data, not being married, short education, and low income are associated with an excessive risk of death from ischaemic heart disease and any disease. The data also indicated that men who were not married and who lived in urban areas might have an increased risk of cerebral stroke and those with a short education an increased risk of cancer.
Notes
Cites: Am J Epidemiol. 1981 Jul;114(1):81-946972694
Cites: Am J Epidemiol. 1982 Apr;115(4):526-377072702
Cites: Eur Heart J. 1981 Oct;2(5):365-737333296
Cites: Biometrika. 1967 Jun;54(1):167-796049533
Cites: Acta Pathol Microbiol Scand Suppl. 1975;SUPPL 252:1-791146549
Cites: Acta Med Scand. 1981;209(4):277-837234503
Cites: J Natl Cancer Inst. 1980 Jan;64(1):17-226928043
Cites: J Epidemiol Community Health. 1980 Mar;34(1):48-527365395
Cites: Scand J Soc Med Suppl. 1980;19:1-846935765
Cites: Br Heart J. 1981 Jan;45(1):13-97459161
Cites: Am J Epidemiol. 1975 Aug;102(2):119-271155441
PubMed ID
7166686 View in PubMed
Less detail

Changes in perceived heart disease risk and health during a community-based heart disease prevention program: the North Karelia project.

https://arctichealth.org/en/permalink/ahliterature239819
Source
Am J Public Health. 1984 Dec;74(12):1404-5
Publication Type
Article
Date
Dec-1984
Author
T E Kottke
P. Puska
J T Salonen
J. Tuomilehto
A. Nissinen
Source
Am J Public Health. 1984 Dec;74(12):1404-5
Date
Dec-1984
Language
English
Publication Type
Article
Keywords
Attitude to Health
Cardiovascular Diseases - prevention & control
Evaluation Studies as Topic
Female
Finland
Health education
Health status
Humans
Male
Questionnaires
Risk
Time Factors
Abstract
To test whether the cardiovascular disease declines in North Karelia were accompanied by subjective improvements in health, we analyzed responses to two questions about perceived risk of heart disease and health status on independent random population samples surveyed 10 years apart. Age stratified perceived risk of heart disease declined significantly more (p less than .01) and age stratified perceived health status improved significantly more in North Karelia than in the reference area (p less than .005).
Notes
Cites: N Engl J Med. 1978 Oct 5;299(14):741-4692548
Cites: Br Med J (Clin Res Ed). 1983 Dec 17;287(6408):1840-46423038
Cites: Med Care. 1982 Jul;20(7):663-756811807
Cites: Br Med J. 1979 Nov 10;2(6199):1173-8519351
PubMed ID
6507696 View in PubMed
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Childhood socioeconomic position and cognitive function in adulthood.

https://arctichealth.org/en/permalink/ahliterature194598
Source
Int J Epidemiol. 2001 Apr;30(2):256-63
Publication Type
Article
Date
Apr-2001
Author
G A Kaplan
G. Turrell
J W Lynch
S A Everson
E L Helkala
J T Salonen
Author Affiliation
Department of Epidemiology, School of Public Health, The University of Michigan, Ann Arbor 48109-2029, USA. gkaplan@umich.edu
Source
Int J Epidemiol. 2001 Apr;30(2):256-63
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adult
Child
Child Development
Cognition Disorders - epidemiology
Education
Finland - epidemiology
Humans
Least-Squares Analysis
Male
Middle Aged
Neuropsychological Tests
Occupations
Parents
Poverty
Risk factors
Socioeconomic Factors
Abstract
Risk of dementia and Alzheimer's disease is higher among adults with limited education, and the less educated perform poorer on cognitive function tests. This study determines whether the socioeconomic environment experienced during childhood has an impact on cognitive functioning in middle age.
A population-based study of eastern Finnish men (n = 496) aged 58 and 64 for whom there were data on parent's socioeconomic position (SEP), their own education level, and performance on neuropsychological tests. Cognitive function was measured using the Trail Making Test, the Selective Reminding Test, the Verbal Fluency Test, the Visual Reproduction Test, and the Mini Mental State Exam.
We found a significant and graded association between parental SEP (combined as an index) and cognitive function both prior to and after adjustment for respondent's education. Those from more disadvantaged backgrounds exhibited the poorest performance. When the separate components of the parental SEP measure were used, father's occupation and mother's education were independently associated with the respondent's score for three and five of the tests, respectively (there was no association with father's education and mother's occupation). After adjustment for the respondent's education, father's occupation was no longer associated with respondent's test score, however, the results were essentially unchanged for mother's education.
Higher SEP during childhood and greater educational attainment are both associated with cognitive function in adulthood, with mothers and fathers each contributing to their offspring's formative cognitive development and later life cognitive ability (albeit in different ways). Improvements in both parental socioeconomic circumstances and the educational attainment of their offspring could possibly enhance cognitive function and decrease risk of dementia later in life.
PubMed ID
11369724 View in PubMed
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Community programme for control of hypertension in North Karelia, Finland.

https://arctichealth.org/en/permalink/ahliterature245355
Source
Lancet. 1980 Oct 25;2(8200):900-4
Publication Type
Article
Date
Oct-25-1980
Author
J. Tuomilehto
A. Nissinen
J T Salonen
T E Kottke
P. Puska
Source
Lancet. 1980 Oct 25;2(8200):900-4
Date
Oct-25-1980
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Cardiovascular Diseases - mortality
Community Medicine
Diastole
Female
Finland
Health education
Humans
Hypertension - prevention & control
Male
Middle Aged
Risk
Systole
World Health Organization
Abstract
A community-based programme to improve awareness and control of hypertension was launched in 1972 in North Karelia. It was incorporated in the existing health-services system. An assessment five years later showed that, compared with a reference area not included in the programme, awareness of hypertension had improved, the prevalence of hypertension had dropped, levels of blood-pressure were lower by age-group, and the number of people on antihypertensive treatment had increased.
PubMed ID
6107554 View in PubMed
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14 records – page 1 of 2.