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E Kaarsalo

Publications and source records attributed to E Kaarsalo.

17 recordsLinked to original sources
PubMed1992

Trends in the incidence of and mortality from coronary heart disease in Finland, 1983-1988.

Trends in the incidence of and mortality from coronary heart disease during the period 1983-1988 were assessed in the population aged 35-64 years in three areas of Finland. The official mortality statistics and the FINMONICA (Finnish portion of the World Health Organization MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) project) Acute Myocardial Infarction Register were used as data sources. They both showed that coronary heart disease mortality declined steeply in Finnish men and women. This marked decline in coronary heart disease mortality was associated with a decline in the number of out-of-hospital coronary deaths. The changes in the incidence of acute myocardial infarction in men did not parallel the changes in mortality. No decline in incidence was seen in women in any of the study areas. These results suggest that the routine mortality statistics alone may give an overly favorable picture of coronary heart disease trends. Data on incidence are necessary to assess the need for the treatment and prevention of coronary heart disease.

Adult↗
PubMed1992

The FINMONICA Stroke Register. Community-based stroke registration and analysis of stroke incidence in Finland, 1983-1985.

In the early 1980s, a standardized community-based stroke register was started in three geographic areas in Finland: North Karelia and Kuopio in eastern Finland and Turku/Loimaa in southwestern Finland. The results from the first 3 years, 1983-1985, confirmed the high incidence of stroke in Finland. The incidence of stroke was higher in eastern Finland than in the southwestern part of the country. The age-standardized annual incidence among men aged 25-74 years varied from 206 per 100,000 population in southwestern Finland to 322 per 100,000 population in the province of Kuopio in eastern Finland. Among women aged 25-74, incidence was 119 and 187 per 100,000 population in these two areas, respectively. The age-standardized male:female ratio in incidence was 1.7, slightly higher than that previously reported in Finland. Out of 3,574 stroke events registered, 78% were first events without a history of previous stroke. People aged 65-74 years accounted for 45% of all events among men and 62% of all events among women. The authors' experience shows that the geographic variation in stroke incidence and attack rates is difficult to assess even within a country with a relatively uniform health care system. Rigorous standardization and quality control is needed for the assessment of long-term trends; this is the primary goal of the FINMONICA Stroke Register. The findings of this study suggest that the incidence of stroke is still high in Finland, although mortality from stroke has steeply declined during the past 15-20 years. The number of stroke survivors in Finland may actually be increasing. Since the occurrence of stroke is high in Finland as compared with other countries, intensified primary and secondary prevention measures are needed to reduce it.

Adult↗
PubMed1992

Diabetes mellitus, impaired glucose tolerance and mortality among elderly men: the Finnish cohorts of the Seven Countries Study.

We studied the association of glucose intolerance with total and cause-specific mortality during a 5-year follow-up of 637 elderly Finnish men aged 65 to 84 years. Total mortality was 276 per 1000 for men aged 65 to 74 years and 537 per 1000 for men aged 75 to 84 years. Five-year total mortality adjusted for age was 364 per 1000 in diabetic men, 234 per 1000 in men with impaired glucose tolerance and 209 per 1000 in men with normal glucose tolerance. The relative risk of death among diabetic men was 2.10 (95% confidence interval 1.26 to 3.49) and among men with impaired glucose tolerance 1.17 (95% confidence interval 0.71 to 1.94) times higher compared with men with normal glucose tolerance. Cardiovascular disease was the most common cause of death in every glucose tolerance group. The multivariate adjusted relative risk of cardiovascular death was increased (1.55) in diabetic patients, albeit non-significantly (95% confidence interval 0.84 to 2.85). Diabetes resulted in an increased risk of cardiovascular mortality among men aged 65-74 years but not among the 75- 84-year-old men. Relative risk of death from non-cardiovascular causes was slightly increased among diabetic subjects. In conclusion, diabetes mellitus is a significant determinant of mortality among elderly Finnish men.

Aged↗
PubMed1992

Acute myocardial infarction (AMI) in Finland--baseline data from the FINMONICA AMI register in 1983-1985.

The acute myocardial infarction (AMI) register of the FINMONICA study, the Finnish part of the WHO-coordinated multinational MONICA project, operates in the provinces of North Karelia and Kuopio in eastern Finland and in Turku, Loimaa and in communities around Loimaa in southwestern Finland. The AMI register serves as an instrument for the assessment of trends in mortality from coronary heart disease (CHD) and of the incidence and attack rates of AMI among 25-64-year-old residents of the study areas. This report describes the methods used in the FINMONICA AMI register and the findings during the first 3 years of the study, in 1983-1985. The criteria of the multinational WHO MONICA project were used in the classification of fatal events and in the diagnosis of non-fatal definite AMI, but based on the experience within the FINMONICA study, stricter diagnostic criteria than those originally described in the WHO MONICA protocol were used for non-fatal possible AMI. This led to a marked improvement in the comparability of the data from the three study areas with regard to the incidence and attack rates of non-fatal AMI. During the 3-year period the total number of registered events was 6266 among men and 2092 among women. Among men the incidence and attack rates of AMI and mortality from CHD were higher in eastern than in southwestern Finland. Also among women the incidence and attack rates of AMI were higher in eastern than in southwestern Finland, whereas there was no regional difference in mortality from CHD among women. The mortality findings of the FINMONICA AMI Register were in good agreement with the official CHD mortality statistics of Finland.

Adult↗
PubMed1991

Epidemiology of subarachnoid hemorrhage in Finland from 1983 to 1985.

The age-standardized incidence of subarachnoid hemorrhage was 33/100,000/yr among Finnish men and 25/100,000/yr among Finnish women. Subarachnoid hemorrhage represented 11% of all strokes detected during 1983-1985 in the community-based stroke register in three areas of Finland. Age-standardized mortality from subarachnoid hemorrhage was 18/100,000/yr among men and 12/100,000/yr among women aged 25-74 years, representing in men 22% and in women 23% of all deaths from stroke in the register. The case-fatality rate of subarachnoid hemorrhage was high: 35% among men and 33% among women within 2 days after the onset of the stroke attack and 48% in men and 46% in women at 1 month. Our findings suggest that the incidence and mortality of subarachnoid hemorrhage in Finland are among the highest worldwide, although differences in criteria, study methods, and classification procedures reduce the comparability of studies from different countries. The occurrence of subarachnoid hemorrhage in our present study is also higher than that previously reported in this country. We believe that this is more likely due to changes in diagnostic classification and improvements in detection of the disease than to a real increase in the morbidity and mortality of subarachnoid hemorrhage.

Adult↗
PubMed1988

Comparison between lovastatin and gemfibrozil in the treatment of primary hypercholesterolemia: the Finnish Multicenter Study.

A randomized, double-blind 12-week comparison of lovastatin and gemfibrozil in the treatment of patients with primary hypercholesterolemia with normal or moderately elevated triglycerides was performed in 334 patients from 19 centers in Finland. Patients with "high" total serum cholesterol (240 to 300 mg/dl) constituted Stratum 1 and patients with "very high" total serum cholesterol (greater than 300 mg/dl) constituted Stratum 2. In Stratum 1, patients were randomly assigned to either lovastatin 20 mg nightly or gemfibrozil 600 mg twice daily, and in Stratum 2 to either lovastatin 40 mg nightly or gemfibrozil 600 mg twice daily. In both strata, the lovastatin dose was doubled after 6 weeks if serum cholesterol remained greater than 200 mg/dl. Ninety-two and 93% of the patients doubled their dose in Strata 1 and 2, respectively, resulting in average doses of 38.5 mg/day (Stratum 1) and 77.4 mg/day (Stratum 1) and 77.4 mg/day (Stratum 2) by week 12. The dose of gemifibrozil was kept constant. Lovastatin reduced low-density lipoprotein (LDL) cholesterol by 31 and 42% in Stratum 1 and 2, respectively. The corresponding reductions achieved by gemfibrozil were 13 and 18%. In both strata, as well as in patients with Type IIa and IIb hyperlipoproteinemia, lovastatin was approximately 2 to 4 times as effective as gemfibrozil in lowering LDL cholesterol. Although both drugs increased high-density lipoprotein (HDL) cholesterol concentrations, gemfibrozil was 1.5 to 3 times more effective. LDL/HDL cholesterol ratios decreased significantly more during lovastatin therapy. Both drugs reduced serum triglyceride levels, but gemfibrozil was much more effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Controlled trial of enalapril and hydrochlorothiazide in 200 hypertensive patients.

In a multicenter, multinational study, 200 patients with essential hypertension were treated with a fixed dose of Enalapril (E) 20 mg/day after a 2- to 4-week placebo period. All had diastolic blood pressure (DBP) 100 to 120 mm Hg at the end of the placebo period. They were then given E for 6 weeks. If DBP after this was greater than 90 mm Hg they were randomized double-blind to added therapy with hydrochlorothiazide (H) either 25 mg/day (E + H 25) or 12.5 mg/day (E + H 12.5) or placebo (E + P) for 4 weeks. Blood pressure was measured approximately 24 hours after taking the medication. In the whole group, BP fell from 171/107 to 156/97 mm Hg during monotherapy with E (P less than 0.001). Sixty-six patients reached DBP less than or equal to 90 mm Hg on E alone. Of the remainder, 42 were randomized to E + P. In these, BP fell by 5.9/3.4 mm Hg (P less than 0.05). Forty-two patients received E + H 12.5 and BP fell by 9.0/6.9 mm Hg (P less than 0.001). Forty-one patients received E + H 25 and BP fell by 5.6/6.3 mm Hg (P less than 0.05/0.01). The proportion of patients who reached DBP less than or equal to 90 mm Hg was 26% in the E + P group, 48% in the E + H 12.5 group (P less than 0.05 compared to E + P group), and 38% in the E + H 25 group. There were no other significant differences between the E + H 12.5 and E + H 25 groups except that S-potassium fell significantly (-0.2 mmol/L) in E + H 25. Both regimens were remarkably well tolerated. It can be concluded that H 12.5 mg/day potentiates the effect of Enalapril 25 mg/day at least as well as H 25 mg/day and better than placebo.

Adult↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1985

Prevalence and incidence of moderate and severe chronic renal failure in south-western Finland, 1973-76.

In an area of south-western Finland with 195 000 inhibitants and a highly centralized health care system, all subjects with elevated serum creatinine (greater than or equal to 230 mumol/l) were registered on the basis of data collected from all hospitals and clinical laboratories of the region. The prevalence of chronic renal failure (S-creatinine greater than or equal to 230 mumol/l) was 67 per 100 000 inhabitants and that of severe chronic renal failure (S-creatinine greater than or equal to 500 mumol/l) 12.3/10(5). The annual incidence of chronic renal failure (S-creatinine greater than or equal to 230 mumol/l) was 31.7 per 100 000 inhabitants and that of severe chronic renal failure (S-creatinine greater than or equal to 500 mumol/l) 11.9/10(5). Age-specific prevalences and incidences rose progressively with age and were very high in the aged population. Chronic interstitial nephritis, in a broad sense, was the most common cause of chronic renal failure, and it was related to analgesic abuse in about half of the cases. Eleven of 68 subjects entering the study with a serum creatinine greater than or equal to 500 mumol/l had no previous knowledge of their chronic renal disease.

Adolescent↗