Inside Trump’s Heart
It’s been a while since Dr. J.’s posted, but the latest edition of ‘Teh Trumpzesz Must Rezign!!!!!!!!!@11!!!Eleventy!!@onE!!!!!!!’ pushes the narrative that Trump is too sick for office, unlike those strapping and robust Presidents Harding, Wilson, Roosevelt, Eisenhower and Kennedy and William Jefferson ‘CABG 4 years after leaving office’ Clinton.
What do we know about President The Donald. (http://abcnews.go.com/Health/read-president-donald-trumps-full-physical-report/story?id=52404444) He’s a 71 year old gentleman, who’s 6’3, 239#. He’s not hypertensive. He has a normal EKG, Normal echocardiogram. Normal stress echo with above average exercise capacity. His Total Cholesterol is 223, LDL 143, HDL 67!, Trigs 129. EBCT score 133. He takes a baby aspirin and 10mg Crestor.
His 10 year estimated risk of MI, stroke or other cardiovascular badness is 16.7%. It’s above the optimal 13%.
Normal cell counts, no real kidney, thyroid, liver tests.
He doesn’t have lung masses. And why should he, he’s never smoked. He has a negative colonoscopy.
He has a perfect Cog Function test.
Dr. J.’s friends Dr. David Maron and Dr. Dan Rader who are preventative medicine gurus were interviewed by the NYT about President Trump’s health.
Dr. Maron is extremely bright and a very thoughtful physician. He is a very aggressive preventative cardiologist and his desire, with his patients is to do everything possible to mitigate their cardiovascular risk. Of course he would be worried about Trump’s risk of a heart attack . He’s a 72 year old man with an elevated cholesterol and a pooch. Dr. J. thinks ‘God, no.’ is an excessively strong response to the question of if Trump is in perfect health, but knowing David, Dr. J. would expect that answer. David would eat Trump to eat ‘bark and twigs’ metaphorically speaking, lose weight (which he does need to do), and probably up the Crestor to 20 mg. Indeed, his doctor, Dr. Jackson is upping the Crestor.
Dr. Rader, was more of a muse in the article, asking more questions than giving answers.
Collectively, David, Dan and Dr. Topol (who Dr. J. met and had lunch with once as a fellow) agreed the CT Calcium scoring test was a waste and overblown. It’s the wrong test for a 71 year old man.
Dr. J. plugged in his numbers into the calculator. Age 46, TC 216, HDL 33, LDL 156, BP 148. His risk was 5.4%/year compared to 1.1%/year which was his ideal. The statin, and BP medications that were added have reduced his risk to 3.0%/year. Indeed Dr. J. will not go down to the optimal risk with modification.
Dr. J. pulled up President Obama’s 2016 physical, and when trying to score his risk, he found an error. The lipids were reported as TC 188, LDL 125, HDL 68 and Tg 42. That is impossible. Total cholesterol = LDL + HDL + Tg/5 or 125 + 68 + 42 which gets you 201. Now we’re quibbling but given all of the dissembling of the Obama administration, the discrepancy should have been noticed by Drs. Gupta, or if presented to my friends they would have noticed lickety split. Anyway, like Obama’s event rate is 7.6%/year which can be reduced to 4.4% with a statin and smoking cessation. His lifetime risk of an event is 50% compared to Dr. J.’s 46%.
So what should we take from the healthscare kerfuffle? Not much. Despite Sanjay Gupta’s alarmist caterwauling about Trump’s coronary artery disease,, he was too cute by half and even Dr. Jackson stated that he Trump has non-obstructive coronary disease. What this means is that yes, he has cholesterol plaques in his coronaries, but you would expect MORE, truth be told, in someone his age Trump is 71, with an elevated cholesterol and a pooch. Relatively speaking while not perfect he looks better than most folks his age, and Dr. J. should look as good. Upping his statin to 20mg will bring his risk for optimum fo this age, which is something that neither Dr. J. nor President Obama can expect to see with risk factor modification. His coronaries look better than President Clinton’s who is the same age. He doesn’t smoke, doesn’t drink. Sorry Democrats, it looks like you’re stuck with him for a long time.
Hey CNN, why don’t you look onto where the 13 points in total cholesterol went in President Obama’s 2016 examination. LIPIDGATE! Dr. J. just can’t even.