As we transition to the presidency of Donald J. Trump, who at age 70 will be the oldest president of the U.S., it’s not too surprising that questions about the health, especially cardiovascular health, of our nation’s leader is a topic of discussion.

During the 2016 presidential campaign Trump released a letter from his physician, Harold N. Bornstein, MD, stating that he (Trump) would be “the healthiest individual ever elected to the presidency.” However, subsequent medical reports have noted that Trump is overweight, has an elevated computed tomography coronary calcium score of 98 consistent with atherosclerotic plaque buildup, and is being treated with statin therapy and aspirin.

"Presidential health will continue to be a subject of discussion, particularly given that people are living longer, healthier lives as a result of advances in medicine and technologies. The chances of having more presidents over the age of 70 in the future are likely good."

Trump is not alone. A historical survey of past presidents shows at least 11 of the last 45 presidents have been affected by cardiovascular disease and/or risk factors.

• President Grover Cleveland served two non-consecutive terms as president (1885 to 1889, and 1893 to 1897). He was obese and died of a myocardial infarction (MI) in 1908 at age 71. Cleveland, an avid cigar smoker, also developed oropharyngeal cancer during his presidency.
• President William Taft served from 1909 to 1913. He was morbidly obese and weighed 340 pounds during his tenure in the White House. He later served in the Supreme Court and died of heart disease in 1930 at age 72.
• President Calvin Coolidge died of a “coronary thrombosis” at age 60 in 1933, four years after leaving the Oval Office.
• President Franklin D. Roosevelt died during his fourth term in office at age 63 following a massive stroke in the setting of malignant hypertension and suspected coronary artery disease. Roosevelt also suffered from complications of polio with lower extremity paralysis.
• President Harry S. Truman was diagnosed with “cardiac asthma” in 1947, two years into his presidency. He later died in 1972 at age 88.
• President Dwight D. Eisenhower, who was 62 at the time of his election to office, sustained an MI in 1955 while playing golf. Eisenhower had started smoking cigarettes while a cadet at West Point and by the time of his MI he was a four-pack-a-day smoker. He ran for re-election in 1956 despite his major MI and subsequent bowel surgery for complications of Crohn’s disease. Eisenhower suffered a stroke in November of 1957 and had multiple recurrent MIs that resulted in progressive heart failure and repeated hospitalizations at Walter Reed Army Medical Center. Eisenhower’s cardiac status continued to deteriorate and he died in 1969 at age 78.
• President Lyndon B. Johnson suffered his first MI in 1955 while serving in the U.S. Senate. He was a heavy smoker and had significant cardiac issues. Johnson suffered another MI in 1972 and died following a subsequent attack in 1973 at age 64.
• President Gerald R. Ford suffered from congestive heart failure, aortic stenosis and coronary artery disease. He died in 2006 at age 93 from complications relating to his cardiovascular disease.
• President George H. W. Bush had a syncopal episode while attending a State Dinner in Japan. He was found to be in atrial fibrillation with rapid ventricular response; the etiology was later attributed to Grave’s disease.
• President William J. Clinton was 58 when he underwent quadruple coronary artery bypass surgery in 2004 for severe triple-vessel disease. Clinton underwent coronary stent deployment in 2010.
• President George W. Bush underwent stent deployment in August 2013 after screening led to the discovery of obstructive coronary artery disease.

Up until the presidency of Dwight D. Eisenhower, details regarding the health of presidents were typically kept from the public out of political calculation. For example, a stroke that incapacitated President Woodrow Wilson in 1919 was kept from the public for several months. In September 1955, the White House announced that President Eisenhower had suffered “digestive upset” to conceal the fact that he had suffered an MI. President Kennedy suffered from Addison’s disease – a fact that was not publicly revealed during the 1960 campaign.

Presidential health will continue to be a subject of discussion, particularly given that people are living longer, healthier lives as a result of advances in medicine and technologies. The chances of having more presidents over the age of 70 in the future are likely good. As such, it’s important that presidents lead by example and make their health – and also the public’s health – a priority. I hope that the White House physician and the Surgeon General will focus on cardiovascular health and the importance of reducing risk factors. The ACC looks forward to working with them, and with the President, to transform cardiovascular care and improve heart health into the future.

John Gordon Harold, MD, MACC, is a past president of the ACC.

Keywords: ACC Publications, Cardiology Magazine, Addison Disease, Aortic Valve Stenosis, Aspirin, Asthma, Atrial Fibrillation, Calcium, Coronary Artery Bypass, Coronary Artery Disease, Coronary Thrombosis, Crohn Disease, Golf, Heart Failure, Hospitalization, Hydroxymethylglutaryl CoA Reductases, Hypertension, Malignant, Japan, Lower Extremity, Male, Myocardial Infarction, Obesity, Morbid, Oropharyngeal Neoplasms, Plaque, Atherosclerotic, Poliomyelitis, Risk Factors, Smoking, Stents, Stroke, Surgeons, Syncope