How Healthy Are Clinton, Trump?

From the WebMD Archives

Sept. 15, 2016 -- The presidential candidates for the two major parties released some personal health information this week, with doctors for both stating they are healthy and fit to serve.

Democratic nominee Hillary Clinton's health information was contained in a two-page letter released Wednesday by her doctor, Lisa Bardack, MD, an internal medicine doctor in Mount Kisco, NY.

Donald Trump also discussed his health Thursday with Dr. Mehmet Oz on The Dr. Oz Show. The Republican nominee provided a letter from his doctor declaring him in “excellent physical health,” but acknowledged he would like to lose some weight.

Trump’s campaign released the letter from his doctor, Harold Bornstein, MD, a gastroenterologist at Lenox Hill Hospital in New York, before the show aired Thursday.

Oz said he has also asked Clinton to appear on the show, and she was considering the invitation.

WebMD asked three doctors for second opinions on the candidates' health. None has treated either candidate, and they emphasize they are speaking generally.

Hillary Clinton

The letter from Clinton's doctor updates a previous medical statement from July 2015. Bardack also discussed the pneumonia responsible for Clinton's dizziness and stumbling at a September 11 memorial service Sunday. At the time, Bardack said Clinton, 68, was overheated and dehydrated; later, it was revealed that Clinton had been diagnosed with pneumonia days earlier.

Clinton's current medications include:

Bardack diagnosed the pneumonia after a scan of the lungs that also included scanning to assess heart disease risk, producing a ''coronary calcium score.'' It evaluates the amount of calcium in coronary arteries, an indication of heart disease risk. Clinton’s calcium score was zero, as it has been in the past. Bardack concludes that Clinton is “in excellent mental condition” and that she is ''healthy and fit to serve as president of the United States."

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Second opinion: Clinton’s pneumonia was not a surprise, given the amount of activity she’s engaged in while campaigning, says Len Horovitz, MD, an internist and lung specialist at Lenox Hill Hospital, New York.

"When you are running around as she is on the campaign trail, you can develop an infection that wouldn't have happened if she had been lying on the couch watching Netflix," he says. Of the Sunday stumbling, he says: "She was probably dehydrated, may have had a fever, that makes you lightheaded, her blood pressure dropped, and she wilted as anyone would."

The calcium score is especially good news, Horovitz says. "A calcium score of zero is like a gold star.”

Based on the data she released, Clinton is ''at low risk for cardiovascular diseases," agrees Hossein Bahrami, MD, PhD, assistant professor of cardiovascular medicine, radiology, and preventive medicine at the Keck School of Medicine of the University of Southern California.

"Her LDL cholesterol (bad cholesterol) is low and her HDL (good cholesterol) is high, which is excellent," he says. "Coronary artery calcium can range from zero to thousands, and the lower it is, the lower the risk of heart diseases would be."

However, the estimators widely used to assess heart disease risk don’t take all factors into account. "For example, physical fitness, obesity, and having certain [coexisting diseases] are not included in these risk estimators,'' and it is left up to the doctor to factor them into any decisions about health, Bahrami says.

“I think she is generally a healthy individual,” says Greg Rosencrance, MD, an internal medicine specialist and chair of the Medicine Institute at Cleveland Clinic.

Donald Trump

In the letter released Thursday, Bornstein says Trump’s cholesterol is within normal ranges, as well as his liver function and thyroid function. Trump told Oz that many of the lab tests were done last week.

Trump has a physical each year, Bornstein says, and a 2013 colonoscopy showed no polyps. (Polyps can be associated with colon cancer.)

Trump’s coronary artery calcium score was 98, which is defined as mild heart disease, but an electrocardiogram (EKG) and chest X-ray done in April were normal, Bornstein says. His PSA test score, a measure of prostate cancer risk, is low.

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Trump takes rosuvastatin, a cholesterol medication, and a low-dose aspirin, the doctor says. Trump told Oz he “actually experimented with three statins, and one seems for me to work the best. It’s really brought my cholesterol down into a good range.” He said he’s been on the statin about 2 years.

In December 2015, Bornstein also issued a letter declaring Trump healthy.

Trump is 6 feet, 3 inches tall and weighs 236 pounds, Bornstein says.

“Your BMI (body mass index) is high,” Oz tells him. Trump’s body mass index, a measure of health taking height and weight into account, is 29.49, or nearly obese.

Trump told Oz he wants to lose 15 to 20 pounds. “If I had one thing, I’d like to lose weight,” he said.

Trump, who initially said he would only speak generally about health, surprised Oz with the test results.

“I feel as good today as I did when I was 30,” he told Oz.

Oz said if a patient of his had similar health records, “I’d be very happy and send them on their way.”

As far as exercise, Trump said he plays golf, although he hasn’t played much recently, and uses “a lot of motion” when he speaks, sometimes in rooms that are crowded and hot. “I guess that’s a form of exercise,” he said.

Second opinion: Trump’s cholesterol numbers are fine, says Horovitz -- but they should be, since he’s on a statin. While his calcium score does indicate mild heart disease, “it’s not a terrible number,” he says.

He agrees Trump should lose weight, saying he would advise a patient to lose the 15 to 20 pounds Trump said he wants to lose.

"We know that men, in general, are at higher risk for cardiovascular diseases" than women are, "even with the same levels of cholesterol and blood pressure,” Bahrami says. “And if they have additional risk factors," such as obesity or high cholesterol (which is assumed since Trump takes a statin), ''the risk is even higher than that."

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Based on his vital signs and test results, Trump “looks healthy other than being overweight,” Rosencrance says.

His cholesterol numbers are good, he says, and his calcium score isn’t too concerning. “It’s not zero, but it puts him in a low-risk category.”

WebMD Health News Reviewed by Hansa D. Bhargava, MD on September 15, 2016

Sources

SOURCES:

Len Horovitz, MD, internist and lung specialist, Lenox Hill Hospital, New York.

Hossein Bahrami, MD, PhD, MPH, assistant professor of cardiovascular medicine, radiology, and preventive medicine, Keck School of Medicine at the University of Southern California, Los Angeles.

New York Times: "Donald Trump Checkup Said to Reveal He Is Overweight," Sept. 14, 2016.

Letter, Harold Bornstein, MD, gastroenterologist, Lenox Hill Hospital, New York, Dec. 4, 2015.

Letter, Lisa Bardack, MD, internal medicine physician, Mount Kisco, NY, Sept. 14, 2016.

Letter, Harold Bornstein, MD, gastroenterologist, Lenox Hill Hospital, New York, Sept. 13, 2016.

The Dr. Oz Show: "Dr. Oz Exclusive: One-On-One With Donald Trump."

Greg Rosencrance, MD, internal medicine specialist and chairman, Medicine Institute, Cleveland Clinic

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