Kush Desai on January 18, 2018
CNN chief medical correspondent Dr. Sanjay Gupta claimed Wednesday that President Donald Trump has heart disease.
Verdict: False
Someone with Trump’s medical profile does not have clinical heart disease, according to several cardiologists. Trump does have a level of plaque buildup that’s normal for someone his age.
Fact Check:
White House physician Dr. Ronny Jackson reported the results of Trump’s first annual physical as president to reporters Tuesday, summarizing that Trump’s “overall health is excellent.”
Gupta asked Jackson during the press conference whether the President has heart disease. “He does not have heart disease,” Jackson replied. After Gupta pressed him for more detail, Jackson acknowledged that a risk indicator for Trump’s heart health has increased.
Gupta cited this exchange the next morning on CNN to claim that Trump has a concerning medical condition.
“There’s no question. By all standards, by all metrics, any way a doctor or cardiologist would look at it, the President does have heart disease,” he said.
Gupta primarily drew on Trump’s coronary calcium score, a measure of calcium levels in major arteries around the heart that reflect plaque build up; plaque-clogged arteries can result in cardiac events such as heart attacks.
“Those numbers qualify him for having heart disease,” said Gupta in a later segment. “And it clearly needs a plan to try and prevent some kind of heart problem down the road.”
Jackson reported that Trump’s calcium score was 133. Scores above 100, as Gupta noted, are associated with a higher risk of complications such as heart attacks.
But Trump is 71 years old, and a calcium score of 133 puts him in the 46th percentile of his age and ethnic cohort. “Even 400 for a man aged 71 isn’t really really high,” Dr. Michael Blaha, cardiologist and director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, explained to The Daily Caller News Foundation.
Jackson described the calcium score as “clinically good information,” and reported that cardiologists he spoke to at several institutions found the results “reassuring.”
Cardiologists stressed to TheDCNF that people tend to build up plaque that calcifies as they age; statistically, around 85 percent of 71-year-old white males record non-zero calcium levels.
“I think the point is that if you have a calcium score of over 100, you have a detectable level of plaque,” cardiologist Dr. Jonathan Reiner of the George Washington School of Medicine and Health Sciences told TheDCNF.
Gupta also pointed to growth in Trump’s calcium score as evidence of heart disease. His calcium score increased from 34 in 2009 to 98 in 2013 to its current score of 133. “You see the trajectory of President Trump’s numbers,” Gupta said. “And they have continued to go up despite the fact that he’s been on medications.”
(Trump’s physical report indicates that he is on Crestor, a statin drug designed to reduce cholesterol and heart attack risk.)
Rising calcium levels could indicate a higher risk, but not all cardiologists would agree that the trend is a serious cause for concern.
“The use of statin medication actually can result in an acceleration of the calcification score going up,” the immediate past-President of the American College of Cardiology Dr. Richard Chazal explained. “Despite the fact that statin reduces the risk of heart attacks.”
But as Jackson conceded when pressed by Gupta, Trump does have some plaque build up. “Technically, he has nonclinical atherosclerotic coronary – coronary atherosclerosis,” Jackson clarified.
Coronary atherosclerosis is sometimes referred to, as Jackson described it, “nonclinical” or pre-clinical heart disease. Atherosclerosis increases the risk of cardiac events such as heart attacks.
But all five cardiologists and several physicians who TheDCNF spoke with expressed skepticism about Gupta’s on-air diagnosis. “It’s a little bit of a weighted statement,” Reiner remarked.
Atherosclerosis is not synonymous with clinical heart disease. “Whether one would define that as ‘heart disease’ is a semantics issue, honestly,” Chazal explained. “It’s a marker that there is plaque present. If one were to define any plaque in any artery as heart disease, then that’s heart disease.”
Dr. Allen Taylor, chief of cardiology at the MedStar Heart and Vascular Institute, explained to TheDCNF that clinical heart disease involves “manifestations” of that plaque build up such as chest pain, heart attacks and heart failure.
Gupta, moreover, relied primarily on Trump’s calcium score and poor diet and exercise habits to diagnose him with heart disease. Many cardiologists and physicians took issue with this, telling TheDCNF that calcium levels alone do not paint a complete picture of heart health. Some even downplayed using calcium scores with their patients altogether.
They instead pointed to indicators such as family history, blood pressure, cholesterol and the results of an echocardiogram – “the gold standard” of heart disease diagnostics, as one cardiologist described it.
Gupta claimed that Trump has heart disease “by all standards, by all metrics,” but Trump’s physical report indicates that most heart metrics are within acceptable ranges for his age. And his echocardiogram actually “demonstrated above average exercise capacity.”
Cardiologists all seem to agree with Gupta, however, on his point that someone with a health profile like Trump’s should make some proactive lifestyle changes. Blaha explained that even his relatively average calcium levels are not nominally healthy.
“It says more about society than anything else,” Blaha remarked.
Gupta did not immediately respond to a request for comment.
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