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[20-year experience with the North Karelia Project. Preventive activities yield results].

https://arctichealth.org/en/permalink/ahliterature219246
Source
Nord Med. 1994;109(2):54-5
Publication Type
Article
Date
1994
Author
P. Puska
E. Vartiainen
J. Tuomilehto
A. Nissinen
Author Affiliation
Avd för epidemiologi och hälsofrämjande, Folkhälsoinstitutet, Helsingfors.
Source
Nord Med. 1994;109(2):54-5
Date
1994
Language
Swedish
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - mortality - prevention & control
Finland - epidemiology
Health education
Humans
Life Style
Male
Middle Aged
Neoplasms - mortality - prevention & control
PubMed ID
8121789 View in PubMed
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Association of hormone replacement therapy with hemostatic and other cardiovascular risk factors. The FINRISK Hemostasis Study.

https://arctichealth.org/en/permalink/ahliterature214240
Source
Arterioscler Thromb Vasc Biol. 1995 Oct;15(10):1549-55
Publication Type
Article
Date
Oct-1995
Author
V. Salomaa
V. Rasi
J. Pekkanen
E. Vahtera
M. Jauhiainen
E. Vartiainen
C. Ehnholm
J. Tuomilehto
G. Myllylä
Author Affiliation
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Source
Arterioscler Thromb Vasc Biol. 1995 Oct;15(10):1549-55
Date
Oct-1995
Language
English
Publication Type
Article
Keywords
Blood Coagulation
Cardiovascular Diseases - prevention & control
Cross-Sectional Studies
Estrogen Replacement Therapy
Female
Finland
Hemodynamics
Hemostasis
Humans
Middle Aged
Risk factors
Abstract
The risk of cardiovascular diseases in women is small until menopause but increases considerably afterwards. When all age groups are considered, cardiovascular diseases are responsible for approximately half of the total mortality in women. It has been suggested that hormone replacement therapy (HRT) in perimenopausal and postmenopausal women could be useful in the prevention of cardiovascular diseases, but its effects are insufficiently known. We performed a cross-sectional study on the associations of menopause and HRT with cardiovascular risk factors, in particular with hemostatic factors, on female participants of the FINRISK Hemostasis Study. The participants, aged 45 to 64 years, were recruited from the Finnish population register by random sampling from three geographically defined areas. The participation rate of women was 83.2%. Of the 1202 women included in the study, 29.2% were current users of HRT. Differences in cardiovascular risk factors by menopausal status and by HRT use were examined after adjustment for age, study area, current smoking, body mass index, self-reported diabetes, and years of education. Postmenopausal women not using exogenous sex hormones had on average a total cholesterol level 0.5 mmol/L (8.9%) higher and an LDL cholesterol level 0.4 mmol/L (11.4%) higher than premenopausal women. Women reporting irregular menstruation (presumably due to perimenopause) had higher adjusted plasma fibrinogen, factor VII coagulant activity, and factor VII antigen than women with regular menstruation or no menstrual periods.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
7583526 View in PubMed
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Cardiovascular diseases and risk factors in Finland.

https://arctichealth.org/en/permalink/ahliterature199712
Source
Prev Med. 1999 Dec;29(6 Pt 2):S124-9
Publication Type
Article
Date
Dec-1999
Author
E. Vartiainen
P. Puska
P. Jousilahti
H J Korhonen
Author Affiliation
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Source
Prev Med. 1999 Dec;29(6 Pt 2):S124-9
Date
Dec-1999
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - epidemiology - prevention & control
Diet, Fat-Restricted
Finland - epidemiology
Health promotion
Humans
Pilot Projects
Primary Prevention
Risk factors
Abstract
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.
PubMed ID
10641830 View in PubMed
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Cardiovascular risk factor changes in Finland, 1972-1997.

https://arctichealth.org/en/permalink/ahliterature67489
Source
Int J Epidemiol. 2000 Feb;29(1):49-56
Publication Type
Article
Date
Feb-2000
Author
E. Vartiainen
P. Jousilahti
G. Alfthan
J. Sundvall
P. Pietinen
P. Puska
Author Affiliation
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland. erkki.vartiainen@ktl.fi
Source
Int J Epidemiol. 2000 Feb;29(1):49-56
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Blood pressure
Cardiovascular Diseases - prevention & control
Cholesterol - blood
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Linear Models
Male
Middle Aged
Prevalence
Risk factors
Sex Factors
Smoking - epidemiology
Abstract
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.
PubMed ID
10750603 View in PubMed
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Change in risk factors for coronary heart disease during 10 years of a community intervention programme (North Karelia project).

https://arctichealth.org/en/permalink/ahliterature241357
Source
Br Med J (Clin Res Ed). 1983 Dec 17;287(6408):1840-4
Publication Type
Article
Date
Dec-17-1983
Author
P. Puska
J T Salonen
A. Nissinen
J. Tuomilehto
E. Vartiainen
H. Korhonen
A. Tanskanen
P. Rönnqvist
K. Koskela
J. Huttunen
Source
Br Med J (Clin Res Ed). 1983 Dec 17;287(6408):1840-4
Date
Dec-17-1983
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Cholesterol - blood
Coronary Disease - etiology - physiopathology - prevention & control
Female
Finland
Follow-Up Studies
Health promotion
Humans
Male
Middle Aged
Risk
Sex Factors
Smoking
Abstract
A comprehensive community based programme to control cardiovascular diseases was started in North Karelia, Finland, in 1972. Reductions in smoking, serum cholesterol concentrations, and blood pressure were among the central intermediate objectives. The effect of the programme during the 10 year period 1972-82 was evaluated by examining independent random population samples at the outset (1972) and five (1977) and 10 (1982) years later both in the programme and in a matched reference area. Over 10 000 subjects were studied in 1972 and 1977 (participation rate about 90%) and roughly 8000 subjects in 1982 (participation rate about 80%). Analyses were conducted of the estimated effect of the programme on the risk factor population means by comparing the baseline and five year and 10 year follow up results in the age range 30-59 years. The effect of the programme (net reduction in North Karelia) at 10 years among the middle aged male population was estimated to be a 28% reduction in smoking (p less than 0.001), a 3% reduction in mean serum cholesterol concentration (p less than 0.001), a 3% fall in mean systolic blood pressure (p less than 0.001), and a 1% fall in mean diastolic blood pressure (p less than 0.05). Among the female population the reductions were respectively, 14% (NS), 1% (NS), 5% (p less than 0.001), and 2% (p less than 0.05). During the first five years of the project (1972-7) the programme effectively reduced the population mean values of the major coronary risk factors. At 10 years the effects had persisted for serum cholesterol concentrations and blood pressure and were increased for smoking.
Notes
Cites: WHO Chron. 1973 Feb;27(2):55-84695971
Cites: Acta Med Scand. 1975 Mar;197(3):211-61124671
Cites: Am J Epidemiol. 1978 Aug;108(2):103-11707471
Cites: Prev Med. 1978 Dec;7(4):539-49756003
Cites: Br Med J. 1979 Nov 10;2(6199):1173-8519351
Cites: Acta Cardiol. 1979;34(6):359-74317405
Cites: Am J Epidemiol. 1981 Jul;114(1):81-946972694
Cites: Lancet. 1981 Dec 12;2(8259):1303-106118715
Cites: Am J Public Health. 1982 Jan;72(1):43-507053618
Cites: World Health Stat Q. 1982;35(1):11-477123990
Cites: Lancet. 1983 May 14;1(8333):1062-66133103
Cites: Lancet. 1983 May 14;1(8333):1066-706133104
Cites: Br Med J (Clin Res Ed). 1983 Jun 11;286(6381):1857-606407602
PubMed ID
6423038 View in PubMed
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Changes in premature deaths in Finland: successful long-term prevention of cardiovascular diseases.

https://arctichealth.org/en/permalink/ahliterature204054
Source
Bull World Health Organ. 1998;76(4):419-25
Publication Type
Article
Date
1998
Author
P. Puska
E. Vartiainen
J. Tuomilehto
V. Salomaa
A. Nissinen
Author Affiliation
Division of Health and Chronic Diseases, National Public Health Institute of Finland, Helsinki, Finland.
Source
Bull World Health Organ. 1998;76(4):419-25
Date
1998
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Cardiovascular Diseases - mortality - prevention & control
Cerebrovascular Disorders - mortality - prevention & control
Female
Finland
Health education
Humans
Male
Middle Aged
Mortality
Neoplasms - mortality
Risk factors
Sex Factors
Abstract
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.
Notes
Cites: World Health Stat Q. 1978;31(3):208-346726509
Cites: Br Med J (Clin Res Ed). 1983 Jun 11;286(6381):1857-606407602
Cites: Int J Epidemiol. 1989;18(3 Suppl 1):S109-172807690
Cites: Stroke. 1996 May;27(5):825-328623100
Cites: BMJ. 1994 Aug 13;309(6952):445-77920128
Cites: Int J Epidemiol. 1994 Jun;23(3):495-5047960373
Cites: Eur J Cancer Prev. 1993 Nov;2(6):457-608287009
PubMed ID
9803593 View in PubMed
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Community screening for HIV infection in Finland.

https://arctichealth.org/en/permalink/ahliterature230985
Source
Am J Public Health. 1989 Apr;79(4):522
Publication Type
Article
Date
Apr-1989
Author
A. Pönkä
K. Cantell
M L Kantanen
P. Leinikki
E. Vartiainen
O. Haikala
S. Hovi
P. Weckström
Source
Am J Public Health. 1989 Apr;79(4):522
Date
Apr-1989
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - prevention & control
Adult
Female
Finland
HIV Seropositivity - epidemiology
Humans
Male
Mass Screening
Middle Aged
Notes
Cites: Lancet. 1986 Jan 18;1(8473):137-92867355
Cites: Br Med J (Clin Res Ed). 1987 Dec 12;295(6612):1503-43122877
Cites: Science. 1987 Nov 6;238(4828):7472823386
Cites: Lancet. 1987 Apr 18;1(8538):9212882321
PubMed ID
2929824 View in PubMed
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Dietary changes in the North Karelia Project (1972-1982).

https://arctichealth.org/en/permalink/ahliterature233348
Source
Prev Med. 1988 Mar;17(2):183-93
Publication Type
Article
Date
Mar-1988
Author
P. Pietinen
A. Nissinen
E. Vartiainen
A. Tuomilehto
U. Uusitalo
A. Ketola
S. Moisio
P. Puska
Author Affiliation
National Public Health Institute, Department of Epidemiology, Helsinki, Finland.
Source
Prev Med. 1988 Mar;17(2):183-93
Date
Mar-1988
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Cardiovascular Diseases - prevention & control
Cholesterol - blood
Dietary Fats - therapeutic use
Eating
Educational Status
Female
Finland
Food Habits
Humans
Male
Middle Aged
Nutritional Sciences - education
Occupations
Abstract
The North Karelia Project is a community-based program to reduce the high cardiovascular disease rates in the province of North Karelia in eastern Finland. Dietary changes aimed at reducing serum cholesterol levels were among the main objectives. The evaluation of the program was based on examinations of independent cross-sectional population samples in 1972, 1977, and 1982 in North Karelia and in a matched reference area. A questionnaire was used to measure changes in dietary habits during the program. A major shift from whole to low-fat milk took place in both areas as well as a reduction in the amount of butter used on bread. The net reduction in North Karelia (difference in change compared with the reference area) in the intake of saturated fatty acids from milk and fat spreads used on bread was 20% in men and 14% in women. This reduction was similar in different age, education, and occupational groups suggesting that the dietary intervention had reached the whole community. The validity of the reported dietary changes was confirmed by parallel changes in serum cholesterol levels.
PubMed ID
3420071 View in PubMed
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Dietary fat and blood pressure: an intervention study on the effects of a low-fat diet with two levels of polyunsaturated fat.

https://arctichealth.org/en/permalink/ahliterature238357
Source
Prev Med. 1985 Sep;14(5):573-84
Publication Type
Article
Date
Sep-1985
Author
P. Puska
J M Iacono
A. Nissinen
E. Vartiainen
R. Dougherty
P. Pietinen
U. Leino
U. Uusitalo
T. Kuusi
E. Kostiainen
Source
Prev Med. 1985 Sep;14(5):573-84
Date
Sep-1985
Language
English
Publication Type
Article
Keywords
Adult
Calcium - urine
Cholesterol - blood
Dietary Fats - administration & dosage
Fatty Acids - blood
Fatty Acids, Unsaturated - blood
Female
Finland
Humans
Hypertension - prevention & control
Magnesium - urine
Male
Marriage
Middle Aged
Potassium - urine
Random Allocation
Sodium - urine
Abstract
The role of dietary fat in human blood pressure control was studied among 84 middle-aged subjects (mainly couples) in two semirural communities in North Karelia, Finland. The families were randomly allocated into two groups that, after a baseline period of 2 weeks, changed their diet for a 12-week intervention period so that the proportion of energy derived from fats was similarly reduced in both groups, from 38 to 24%, but the polyunsaturated/saturated fatty acid (P/S) ratio was increased--from 0.2 to 0.9 in group I and to 0.4 in group II. After the intervention period, both groups switched back to their usual diet for a period of 5 weeks. During the intervention period, total serum cholesterol was reduced by 16% in group I and 14% in group II. Mean body weight and urinary sodium, potassium, calcium, and magnesium excretion changes were small or nonexistent. Mean systolic blood pressure decreased 4 mm Hg in group I (P less than 0.01) and 3 mm Hg in group II (P less than 0.01), and mean diastolic blood pressure decreased 5 mm Hg (P less than 0.001) and 4 mm Hg (P less than 0.01), respectively. The reductions were reversed during the switch-back period (P less than 0.01). These results confirm previous findings of the blood-pressure-reducing effect of a low-fat/high-P/S diet. Although a number of possible confounding factors can be ruled out, the dietary constituent accounting for the blood pressure change cannot be ascertained definitely. The results showed no significant further blood pressure reduction with more than a moderately increased P/S ratio when the saturated fat intake was markedly reduced.
PubMed ID
4070190 View in PubMed
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A disparity in the association of asthma, rhinitis, and eczema with allergen-specific IgE between Finnish and Russian Karelia.

https://arctichealth.org/en/permalink/ahliterature165178
Source
Allergy. 2007 Mar;62(3):281-7
Publication Type
Article
Date
Mar-2007
Author
P T Pekkarinen
L. von Hertzen
T. Laatikainen
M J Mäkelä
P. Jousilahti
T U Kosunen
V. Pantelejev
E. Vartiainen
T. Haahtela
Author Affiliation
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Source
Allergy. 2007 Mar;62(3):281-7
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Allergens - immunology
Antibody Specificity
Child
Dermatitis, Atopic - blood - prevention & control
Female
Finland - epidemiology
Humans
Immunoglobulin E - blood - immunology
Male
Questionnaires
Respiratory Hypersensitivity - blood - prevention & control
Russia - epidemiology
Abstract
A substantial variation in the association of asthma, rhinitis and eczema with elevated serum allergen-specific immunoglobulin E (sIgE) levels between different populations has been reported. Here, we wanted to clarify whether these proportions are different in Finnish and Russian Karelia, and compared the ability of questionnaires, skin prick tests (SPT) and sIgE measurements to detect atopic conditions in these adjacent areas with different living conditions.
Randomly selected schoolchildren, aged 6-16 years, and their mothers from Finland (n = 344 children, 344 mothers) and Russia (427 and 284 respectively) participated. SPTs and sIgE measurements to common inhalant and food allergens were performed. The occurrence of asthma, rhinitis, eczema and related symptoms was assessed with an International Study of Asthma and Allergies in Childhood-based questionnaire. Correlation between SPT and sIgE was estimated using the Spearman correlation coefficient.
The rate of positive sIgE results was significantly higher in Finland among both mothers and children. Seventy-seven per cent of Finnish children and 43% of Russian children with asthma were sIgE positive. The respective figures for hay fever were 94% and 67%, and for eczema 68% and 41%. This discrepancy was similar but of lower magnitude among mothers. The overall occurrence of asthma, rhinitis and eczema was very low in Russian Karelia. The correlation between SPT and sIgE results was generally good.
Asthma, rhinitis and eczema in Russian Karelia are not only rare but also, to a large extent, have no sIgE component. Therefore, the ability of questionnaires to detect sIgE-mediated atopic conditions in this area of Russia is poor.
PubMed ID
17298345 View in PubMed
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35 records – page 1 of 4.