No increase in the prevalence of COPD in two decades.

Relevant information on the prevalence of chronic obstructive pulmonary disease (COPD) and its trends is scarce. In the present study, we compare the prevalence rates and potential determinants of COPD in two national population samples that were surveyed 20 yrs apart. In 1978-1980, a sample of 8,000 people was surveyed; subjects were representative of the Finnish population and were aged ≥30 yrs. Among those aged 30-74 yrs, acceptable spirometry was obtained from 6,364 (87%) subjects. In a similar survey conducted in 2000-2001, comparable spirometry was obtained from 5,495 (80%) participants. Airway obstruction was defined as forced expiratory volume in 1 s (FEV(1))/forced vital capacity below the lower limit of normal and staged for severity on the basis of FEV(1) % predicted. The age-adjusted prevalence rates of obstruction (stages I-IV) were rather similar in both surveys in males (4.7 versus 4.3%; p = 0.25), but were almost significantly higher in females in the later survey (2.2 versus 3.1%; p = 0.06). The rates of COPD stage II or higher were 3.9% in 1978-1980, and 3.6% in 2000-2001 (p = 0.36) for males, and 1.4 and 1.5% (p = 0.93), respectively, for females. In conclusion, no significant difference was found in the prevalence of COPD stages II-IV between similar population based surveys performed 20 yrs apart. Since COPD is mostly mild or moderate there is a strong case for early prevention.

Prevalence, detection and drug treatment of hypertension in a rural Australian population: the Greater Green Triangle risk factor study 2004-2006.

BACKGROUND: Hypertension is an important risk factor for cardiovascular disease; however, limited findings are available on its detection and management in rural Australia. AIM: To assess the prevalence, awareness and treatment of hypertension in a rural South-East Australian population. METHODS: Three cross-sectional surveys in Limestone Coast, Corangamite Shire and Wimmera regions during 2004-2006 using a random population sample (n = 3320, participation rate 49%) aged 25-74 years. Blood pressure was measured by trained nurses. Information on history of hypertension and medication was obtained by questionnaires. Hypertension was defined as systolic blood pressure >or=140 mmHg and/or diastolic blood pressure >or=90 mmHg and/or on antihypertensive drug treatment. RESULTS: Overall, one-third of participants had hypertension; of these, two-thirds, 54% (95% confidence interval (CI) 47-60) of men and 71% (95% CI 65-77) of women, were aware of their condition. Half of the participants with hypertension were treated and nearly half of these were controlled. Both treatment and control were more common in women (60%, 95% CI 54-67 and 55%, 95% CI 47-64) compared with men (42%, 95% CI 36-49 and 35%, 95% CI 26-44). Monotherapy was used by 55% (95% CI 48-61) of treated hypertensives. Angiotensin-converting enzyme inhibitors were the most frequently used class of antihypertensive drugs in men, whereas angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists and diuretics were all widely used among women. CONCLUSION: This study emphasizes suboptimal detection and treatment of hypertension, especially in men, in rural Australia.

Self rated health and mortality: a long term prospective study in eastern Finland.

STUDY OBJECTIVE: To assess the relation between self rated health and mortality over a period of 23 years, taking into account medical history, cardiovascular risk factors, and education at the beginning of the follow up. DESIGN: A cohort of random population samples. The baseline studies included a self administered questionnaire and a health examination. Mortality data were collected from the national mortality register using personal identification numbers. SETTING: The provinces of North Karelia and Kuopio in eastern Finland. PARTICIPANTS: Random samples of working age people (n=21 302) from the population register. MAIN RESULTS: For self rated health, the age adjusted poor to good relative risk for all cause mortality was 2.36 (95% confidence intervals 2.10, 2.64) for men and 1.90 (1.63, 2.22) for women, and for cardiovascular mortality 2.29 (1.96, 2.68) for men and 2.34 (1.84, 2.96) for women. Adjusted for selected potentially fatal diseases from the subjects' medical histories, cardiovascular disease risk factors, and education, the corresponding relative risks for all cause mortality were 1.66 (1.47, 1.88) for men and 1.50 (1.26, 1.78) for women, and for cardiovascular mortality 1.54 (1.29, 1.82) for men and 1.63 (1.26, 2.10) for women. The association between self rated health and mortality attributable to external causes was fairly strong. CONCLUSIONS: Poor self rated health is a strong predictor of mortality, and the association is only partly explained by medical history, cardiovascular disease risk factors, and education.

Self-reported health in the Republic of Karelia, Russia and in north Karelia, Finland in 1992.

BACKGROUND: Major differences in mortality, cardiovascular disease risk factors and health behaviour are known to exist between the populations of eastern Finland and the Republic of Karelia, Russia. Little is known, however, whether similar differences exist in subjective health. METHODS: In spring 1992 a population survey was conducted in North Karelia, Finland and in the area of Pitkäranta, Republic of Karelia, Russia. Random population samples (n = 2,000 in North Karelia and n = 1,000 in Pitkäranta) stratified for age and sex were taken from the population registers. The subjects completed questionnaires and were examined at local health centres. RESULTS: In North Karelia 50% of men reported their health as being quite good or very good, compared to 34% in Pitkäranta (p < 0.0001 for area difference). Among women the corresponding percentages were 58% in North Karelia and 22% in Pitkäranta (p < 0.0001). High household income and education were associated with good self-rated health among both sexes in North Karelia and among women but not men in Pitkäranta. Self-reported physical condition was better in North Karelia than in Pitkäranta (p < 0.0001). Psychosomatic symptoms (p = 0.0002 among men and p < 0.0001 among women) and many somatic symptoms were more prevalent in Pitkäranta than in North Karelia. CONCLUSION: In general, people in North Karelia, Finland feel healthier than people in the neighbouring Republic of Karelia, Russia. Socioeconomic differences in subjective health are less prominent in the Republic of Karelia.

Trends of back pain in eastern Finland, 1972-1992, in relation to socioeconomic status and behavioral risk factors.

The aim of this study was to compare the trends in the prevalence of back pain between several population subgroups and to assess the stability of the associations between back pain and its potential risk factors. Five cross-sectional surveys with independent random samples were conducted in two provinces in eastern Finland every fifth year from 1972 to 1992. There were 29,043 respondents aged 30-59 years. The respondents completed a questionnaire that asked about the occurrence of back pain during the preceding month. The prevalence of back pain varied between 46 and 50 percent among men and between 46 and 51 percent among women. In general, the trend for the entire sample was fairly stable, but the prevalence rates seemed to differ considerably between subgroups of the population. Back pain was more prevalent among those with lower education and income, those with blue-collar occupations, and those doing heavy work. The trends were significantly inconsistent (p < 0.05), for example, between the categories according to household income and, among men, between the categories according to body mass index, a suspected risk factor for back pain.

Trends in self-rated health in Finland 1972-1992.

BACKGROUND: Self-rated health is a useful indicator of the population's health. Yet follow-up studies on perceived health trends are scarce. The aim of this paper is to assess perceived health trends in Finland between 1972 and 1992. METHODS: Five cross-sectional studies were done in two areas in eastern Finland every 5th year since 1972 and in a third area in southwestern Finland since 1982. The total number of respondents was 33,962. The respondents filled in a questionnaire, followed by a health examination. The subjects were categorized by age, education, and household income. RESULTS: In 1972, one-third of the population reported good health, whereas in 1992 the rates were 50 and 60% for men and women, respectively. Younger persons reported better general health than older persons. High education and high household income were undisputed indicators of good health. Among men, their importance as predictors of good health diminished during the 20 years. CONCLUSIONS: Finnish people today not only live longer but also feel healthier. In order to achieve good health for all population groups we need continual efforts to diminish the socioeconomic disparities.