Showing papers by "Pekka Puska published in 1981"

Changes in smoking, serum cholesterol and blood pressure levels during a community-based cardiovascular disease prevention program—the north karelia project

Abstract: A comprehensive community-based program to control cardiovascular disease was carried out in North Karelia, Finland, in 1972--1977 Reductions in smoking, serum cholesterol and blood pressure (BP) levels were among the central intermediate objectives The effect was evaluated by examining independent population samples at the outset and at the end, both in the program area and in a matched reference area More than 10,000 subjects were studied each time (participation rate about 90%) This paper presents the analyses of the estimated effect of the program on the risk factor means by comparing the baseline and terminal situations among the population aged 30--59 years The effect of the program among men was estimated to be a reduction of 13% in smoking, 4% in serum cholesterol and 3% in systolic and diastolic BP means Among women, there was a net reduction of 5% in systolic BP and 4% in diastolic BP means The net reductions in smoking (8%) and serum cholesterol (1%) among women were within sampling variation It is concluded that the population means of the major coronary heart disease risk factors were reduced during the program more in the intervention area than in the reference area, and it seems likely that most of this difference was due to the program

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

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.

Sodium intake reduction in volunteer families by using a salt substitute and nutrition counselling.

Abstract: A double-blind study on the home use of regular salt (RS) and a salt substitute, called Mineral Salt® (MS), was done in 58 volunteer families all with a 13-year-old child. All the salt used at home was replaced by one of the test salts for 4 months. After the first 2 months the parents were given a 5-hour course on reducing sodium intake by changing food habits. The test salt consumption was measured by weighing the leftover salt after 2 and 4 months. The parents and 13-year-old children collected 24-hour urine samples at the beginning of the study and after 2 and 4 months. The home use of test salt fell from 2.9 to 2.6 g/family member in the RS group (nonsignificant) and from 3.4 to 2.9 g in the MS group (significant at p

The Relation of Physical Activity Changes to Changes in Serum Cholesterol and Body Weight in a Three-Year Follow-up of Population Sample

Abstract: The purpose of this study was to analyse relationships between change in physical activity and change in serum cholesterol and body weight in a cohort representative of the general population, and their interaction with dietary changes. When controlling for changes in diet, changes in physical activity had little impact on serum cholesterol changes. Dietary changes did not modify this relationship significantly. Physical acitivity changes were more reflected on weight changes.

A community-based hypertension register as a part of a systematic hypertension control project: experiences from the North Karelia project.

Abstract: A community control programme for hypertension was instituted during 1972 and 1977 as a major subprogramme of the North Karelia project. The aim was to reduce the high blood-pressure levels prevalent among the whole population of the county of North Karelia. A community-based hypertension register, established according to the recommendations of the WHO, served as a central information system and ensured the continuous follow-up of the hypertensive patients. During the period May 1972 to April 1977 17 014 hypertensive subjects were registered (9-7% of the total population). The registered subjects were followed-up annually. The build-up of the registration system took two to three years, the system proved to be feasible, the percentage of non-participants during the follow-up was between 14 and 16% and the amount of missing data was insignificant.Un programme de surveillance de la population pour l'hypertension fut mis en place de 1972 a 1977 dans le cadre du projet de Carelie du Nord. Le but etait dedimi...