Health tests for candidates on the campaign trail at ages 78, 77, 70, 77 and 73
The Associated Press
Will Weissert and Lauran Neergaard
Bernie Sanders suffered "modest heart muscle damage" during his recent heart attack but has since recovered well and is fit enough for the rigors of the presidential campaign and the White House should he win it, according to letters released Monday by his primary care physician and two cardiologists.
The 78-year-old Vermont senator is the oldest candidate in the 2020 presidential race and had vowed to release detailed medical records by the end of the year. His campaign did so the day before New Year's Eve, and the letters provide the most detail it has given to date showing that Sanders received prompt treatment to reopen his clogged artery with stents following his heart attack, which occurred while he campaigned in Las Vegas on Oct. 1.
After a first heart attack, standard questions include the likelihood of another and whether the heart's muscle was damaged badly enough to trigger later heart failure. While his heart was damaged, Sanders has had no other symptoms, his blood pressure and heart rate are "in optimal ranges," and his heart is functioning normally, with the ability to exercise "well above average," wrote his cardiologist, Dr. Martin LeWinter, of the University of Vermont Medical Center.
The key test to show that was a treadmill exercise test in which doctors watch for signs of trouble during strong exertion. Sanders' exercise capacity this month was "average" for a healthy man his age without heart disease, and he was able to exercise to a level about 50 percent higher than men his age who do have heart disease, wrote University of Vermont cardiac rehabilitation chief Dr. Philip Ades and exercise physiologist Patrick Savage in a separate letter.
"At this point, I see no reason he cannot continue campaigning without limitation and, should he be elected, I am confident he has the mental and physical stamina to fully undertake the rigors of the presidency," LeWinter wrote, also noting that Sanders had made an "uneventful" recovery from his heart attack.
Sanders' heart attack occurred in an artery often called the "widow-maker," and the fact that he received prompt treatment to reopen that blood vessel helps explain how well he's doing, said Dr. Mary Ann McLaughlin, director of cardiovascular health and wellness at Mount Sinai Heart in New York. She reviewed Sanders' health information.
She was reassured by the exercise testing that Sanders' heart is strong.
"I do not see a reason why he would not be able to function effectively in a high stress job," she said. "Fortunately the stress test revealed normal blood flow to his heart."
The stents that propped open his artery do carry a risk of blood clots, so it's important that he stay on his blood-thinning medication long term, McLaughlin noted.
Sanders is taking additional medications that are routine after a heart attack, including a blood pressure medicine that also can improve function after damage to heart muscle, she noted. He also uses a statin to keep his cholesterol in check and another medication for an unrelated condition, low thyroid levels.
A letter from Brian Monahan, the congressional attending physician in Washington, noted that Sanders was initially taking additional medications after his heart attack but that those "were stopped based on your progress."
"Your heart muscle strength has improved. You have never had symptoms of congestive heart failure," Monahan wrote to Sanders. "The heart chamber sizes, wall thickness, estimated pressures, and heart valves are normal."
He added: "You are in good health currently and you have been engaging vigorously in the rigors of your campaign, travel, and other scheduled activities without any limitation."
Sanders spent several days post-heart attack recuperating in his Vermont home. He's said previously that he had felt symptoms for weeks that he "should have paid more attention to," including being especially fatigued after long campaign days, having trouble sleeping and sometimes feeling a "little unsteady" at the podium while speaking at events.
The senator's staff initially said stents were inserted for a blocked artery, revealing only two days after he was first hospitalized that he had suffered a heart attack. Sanders has bristled at the notion that his campaign was less than forthcoming about his condition, saying that it released as much information as it could, as fast as possible, and that the full details only came later.
Sanders is the latest in a string of Democrats 70 and older to release medical records as age continues to be a factor in the race.
Former Vice President Joe Biden, 77, had promised to release his medical records before the Iowa caucuses on Feb. 3. A doctor's report issued earlier this month said Biden is in overall good shape and keeps his cholesterol at healthy levels with the use of a statin medication. He's also had a persistent irregular heartbeat.
Also this month, 70-year-old Elizabeth Warren released a note from her doctor saying that she is "in excellent health" and that her only major medical concern is an underactive thyroid gland, which the Massachusetts senator easily treats with medication, the only kind she takes.
Michael Bloomberg's doctor declared the 77-year-old former New York City mayor to be in "outstanding health," though he is receiving treatment for several medical conditions, including an irregular heartbeat. Bloomberg also had a stent put in his heart to clear an artery in 2000.
Donald Trump, now 73, became the oldest newly inaugurated first-term president in January 2017. He has been criticized for releasing only cursory details on his health while running for the White House.
On a Saturday in November, Trump visited Walter Reed National Military Medical Center, a stop that wasn't listed on the president's schedule and came just nine months after his last physical. Trump later said he went through a "very routine physical" and blamed the media for sparking unfounded fears that the visit meant he was ill.