Trump's Doctor Says Health Excellent, Attributes 'Good Genes'

Alicia Ault

Disclosures

January 16, 2018

President Donald J. Trump is extremely healthy for his age and has no cognitive deficits, said his physician in a briefing to reporters on the results of a 4-hour exam conducted in consultation with a dozen specialists.

The White House physician, Navy Rear Admiral Ronny Jackson, MD, examined the president, age 71, on January 12 at the Walter Reed National Military Medical Center in Bethesda, Maryland. During the exam, the president received the Prevnar 13 pneumococcal vaccine and a second dose of the Twinrix vaccine for hepatitis A and B.

Dr Jackson repeated the assertion he made just after the exam that "the president's overall health is excellent," and added, "I feel very confident that he has a very strong and a very probable possibility of making it completely through his presidency with no serious medical issues."

Trump is extremely healthy despite existing on 4 to 5 hours of sleep a night and subsisting on a high-fat, junk food-laden diet, said the physician. He attributed that to genetics. "He has incredibly good genes, and that's just the way God made him," Dr Jackson said.

However, Dr Jackson said he would be encouraging the president to cut more fat and carbohydrates from his diet and to take up a daily exercise regimen — he currently does not exercise — most likely a low-impact aerobic activity, as a means of getting him to lose weight and lower any potential cardiac risk.

All of the president's organ systems and joints were found to be normal, and most of his cardiac measures fell in the normal range. Even his eyes were described as exemplary. His uncorrected vision is 20/30, which means he can drive without glasses, said Dr Jackson. But he has a history of hypercholesterolemia and has been noted to have what Dr Jackson called "nonclinical" coronary atherosclerosis in the past and in the current exam.

At 75 inches (6.25 feet) and 239 pounds, the president has a body mass index of 30.7, which is considered obese. Even so, he is not prediabetic. He had a fasting glucose of 89 and a hemoglobin A1C of 5% — a normal measure.

Trump is taking a 10-mg daily dose of rosuvastatin (Crestor, AstraZeneca), 81 mg daily of aspirin for heart attack prevention, finasteride (Propecia, Merck) to treat male-pattern baldness, and antibiotics for rosacea.

His blood pressure was 122/74 and his resting heart rate was 68. His total cholesterol was 223; his triglycerides were 129; HDL was 67; and, LDL was 143. The ratio of total cholesterol to HDL was 3.3.

His triglycerides and LDL have increased significantly since the president's last reported measures in 2016, when his LDL was 94 and triglycerides were 61. His HDL at the time was 63. Dr Jackson said he hoped a diet and exercise program would help reduce the LDL figure.

Palpation of the carotid arteries was normal, and an electrocardiogram revealed a normal sinus rhythm of 71 and a normal axis. A transthoracic echocardiogram showed normal left ventricular systolic function, with a 60%-to-65% ejection fraction, a normal left ventricular size and wall thickness, a normal right ventricle, and all normal valves. The president underwent an exercise stress echocardiogram that "demonstrated above-average exercise capacity based on age and sex," said Dr Jackson.

In 2013, President Trump had a coronary artery calcium score of 98. It has risen to 133, but conversations with cardiologists at Walter Reed, the Cleveland Clinic, and elsewhere indicated that the increase was not a concern because it has not gone up that much over time, Dr Jackson said.

Cognition Assessed at Trump's Request

Dr Jackson said he had not planned to assess the president's cognitive abilities because most guidelines seemed to indicate it was not necessary unless family and friends had observed troubling behavior. Dr Jackson said he had been given no reason to doubt the president's mental fitness in just over a year of closely interacting with him.

Instead, Trump asked him to conduct an assessment — not in response to any particular event, but in an effort to put questions to rest, said Dr Jackson. "He wasn't obviously the least bit concerned that he had anything to hide," said the physician.

Dr Jackson employed the Montreal Cognitive Assessment (MoCA), a longer, more involved screening test. "The president did exceedingly well on it," scoring 30 out of a possible 30, said Dr Jackson.

With such a great result, "It does rule out the need to do any other cognitive testing," said the physician.   

He said he did not consult with any psychiatrists or psychologists on the president's emotional well-being, saying it was not necessary.

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