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[Prospective trial of 40-59-year-old males with angina pectoris and essential hypertension (results of 30-35-year prospective studies)].

AIM
To investigate remote prognosis for patients with coronary heart disease and essential hypertension with consideration of the initial total serum cholesterol (TSC) level.


MATERIALS AND METHODS
Throughout 30-35 years 103 male patients aged 40-59 years with angina pectoris and essential hypertension were examined (repeated evaluation of protein and lipid spectrum, normal resting and two-step exercise ECG). At the entry, the patients had no history of myocardial infarction (MI), cerebral thrombosis, heart failure, discirculatory encephalopathy. Causes of death were verified by the data of autopsy (70.3%) and registry office's records. Adequate data were obtained on 93 of 103 patients (90.3%).


RESULTS
By the end of the trial 89 of 93 patients died. 78 (87.6%) of them died of MI or stroke. 44 deceased from the subgroup with low TSC level lived, on the average, 65.9 +/- 1.3 years, while 45 deceased from the subgroup with high TSC lived 67.9 +/- 1.4 years, i.e. 2 years longer. The worst life prognosis was for patients who developed cancer. They lived 60.5 +/- 5.1 years, i.e. 7.5 years less than the rest of the deceased. In the subgroup with low TSC level there were 5 times more deceased due to cancer than in the subgroup with high TSC level.


CONCLUSION
Patients of middle and old age with coronary heart disease require a strictly individual approach to correction of their lipid metabolism and special alertness for cancer in low TSC level.