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Trump has common form of heart disease

CNN's Chief Medical Correspondent Dr. Sanjay Gupta weighs in on President Trump's medical exam, saying the numbers provided by Dr. Ronny Jackson prove the president has heart disease.

Posted: Jan 18, 2018 12:05 PM
Updated: Jan 18, 2018 12:05 PM

Like most men of his age, President Donald Trump has a common form of heart disease, relatively easy to address if he increases the dose of his cholesterol-lowering medication and makes necessary lifestyle changes. Without those changes, the President has a moderate risk of having a heart attack in the next three to five years, according to the Mayo Clinic.

On Tuesday, White House physician Dr. Ronny Jackson disclosed Trump's basic labs measurements, physical exam results and the conclusion of a cognitive exam, known as the Montreal Cognitive Assessment. Additionally, the President had an echocardiogram of his heart, as well as a stress test, both described as normal. Although it was not part of the official medical records that were released yesterday, after further questioning, Jackson also revealed that Trump underwent a coronary calcium CT scan as part of his routine physical exam.

His score is 133, and anything over 100 indicates plaque is present and that the patient has heart disease. According to Trump's official medical records, in 2009 his coronary calcium score was 34. In 2013, it was 98.

Most people might have not heard of this test, also known simply as a heart scan or calcium score. It is a CT scan, a specialized X-ray that takes high quality pictures of the heart, looking for calcium-containing plaque in the blood vessels that feed the heart, known as the coronaries. With this information, doctors can then calculate the risk of having a heart problem in the future. In the case of Trump, a new score of 133 reveals there has been a steady build-up of plaque in his blood vessels, indicating moderate heart disease. Also concerning are Trump's total cholesterol levels and his LDL ("bad" cholesterol), as both increased significantly over the last year, despite being on a statin drug known as Crestor or Rosuvastatin.

Trump, 71, is not too different than most Americans his age. After the age of 40, most men in the United States have some evidence of heart disease, and the President's score places him squarely in the mid-risk range for a man of his age. Because the President doesn't smoke or drink and "appears to have good genes," according to Jackson, he has been able to avoid the classic symptoms of heart disease.

"His score is 133 and he is 71 years of age, which puts him in the 46 percentile," said cardiologist Dr. Rachel Bond of Lenox Hill Hospital in New York. "What does this indicate? Yes, he certainly has coronary artery disease because calcium is present. But this is also common for someone his gender, race and age.

"When I compare him to other males who are 71 and white, only 46% of others have a better score than him."

Bond added this is not something to be taken lightly.

A coronary calcium score below 100 reduces the risk of heart attack to moderate.

Jackson has already increased the dosage of the Trump's cholesterol-lowering medication and recommended a low-carbohydrate and low-fat diet, along with an exercise regimen.

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