Medical History Summary: President
George W. Bush
August 7, 2007
President George W. Bush had a physical
examination by his doctor on August 6,
2007. According to the summary of his
results and medical history released by
the White House, he is in "the
'superior' fitness category for men his
age. Unlike Vice President Cheney, Bush
has a 'low' to 'very low' coronary
artery disease risk profile. While Pres.
Bush “does not regularly use
prescription medications,” the White
House said that he takes a multi-vitamin
The medical report asserted that Bush
does not drink any alcohol, but has “an
occasional cigar” He does drink
caffeine, however, in diet sodas and
He allegedly exercises six times a week,
and his “workouts include cycling,
elliptical trainer, resistance training,
and flexibility exercises.”
With a date of birth of July 6, 1946, the
President is 61 years old.
Past Medical History
There is no past medical history of
hypertension, diabetes, tuberculosis,
sexually transmitted disease, or stroke. The
President benefits from a “low” to “very
low” (favorable) coronary artery disease
risk profile with a favorable family medical
history, absence of modifiable risk factors;
superior fitness, favorable CAD markers
(e.g. CRP, lipids) and functional studies
(“stress echocardiogram”), and
“minimal/mild” coronary artery calcification
noted on anatomic study (coronary artery
computed tomography, 12/2004).
Erythema migrans consistent with early,
localized Lyme disease, treated, with
complete resolution and without recurrence,
Actinic keratoses identified and treated
with liquid nitrogen.
Telangiectasias, nasal bridge, consistent
with solar damage; treated 8/03.
Vasovagal syncope, 1/02; solitary episode
with identifiable precipitating event
superimposed on longstanding, non-pathologic
sinus bradycardia (consistent with a
conditioned heart); evaluation 1/02, no
sequelae, and no recurrence since 1/02.
Adenomatous colonic polyps (5 tubular
adenomas, each < 1.0 cm without advanced
features) removed on surveillance
colonoscopy 7/07. Repeat colonoscopy is
indicated in 3 years.
Mild high frequency hearing loss documented
and stable on prior exams; speech
frequencies excellent. Currently no
History of seasonal allergic rhinitis;
asymptomatic this spring with preventive
seasonal use of nasal corticosteroid spray.
The President has a history of
activity-related injuries as noted below,
which resolved without sequelae and do not
impact his current duties. He continues a
vigorous aerobic, weight training, and
Musculoskeletal low back pain secondary to
heavy lifting and tight “hamstrings”; fully
evaluated in 1990; asymptomatic due to
current exercise and flexibility program.
Intermittent bilateral anterior knee pain,
activity-related, with a left medial
meniscal injury and subsequent surgical
repair in 1997. Orthopedic and radiographic
re-evaluation in 12/03 confirmed an old
incomplete tear of the PCL of the right knee
with resultant patello-femoral
chondromalacia, post-traumatic degenerative
changes, and asymptomatic medial meniscal
damage, all most consistent with a remote
athletic injury and physical activity.
Symptoms resolved with quadriceps
strengthening, cross-training (biking), and
elimination of routine impact exercises
(e.g. running) from his routine.
Right “calf” running injury (strain/tear),
4/03, most consistent with overuse. Symptoms
Minor abrasions and lacerations secondary to
injuries sustained while biking, all healed
Gastroesophageal reflux with well-defined
triggers, 2005, without recurrence.
Vitreous floaters, infrequent, evaluated by
retinologist 3/06; examination normal for
age (non-pathologic age-related changes
Mild hyperopic astigmatism/presbyopia, fully
correctable. Uses reading glasses as-needed
Blood transfusions: none.
Past Surgical History
Left medial menisectomy as above, 3/97
The President takes a daily multi-vitamin.
He does not routinely use prescription
The President’s immunizations are current
for worldwide travel.
Tobacco: An occasional cigar
Caffeine: Diet sodas and coffee
Exercise: The President exercises six times
per week. Workouts include cycling,
elliptical trainer, resistance training, and
Other: A viral illness prompted
rearrangement of the President’s schedule at
a morning session of the G8 in June. The
President has not otherwise missed work due
to illness since his last physical exam.
Age: 61 years old
Height: 71.50 inches (without shoes)
Temperature: 97.8 degrees F (oral)
Weight: 192.0# (last year 196.0#)
Body Composition: Body fat 16.6% (last year
16.8%; normal for age 16.5-20.5%; Cooper data)
Resting heart rate (seated): 52 bpm
Resting blood pressure (seated): 117/71
System-specific examination summary
ENT (ears, nose, and throat): Physical
examination of the head, neck, and thyroid are
normal except for a serous otitis media as well
as signs and symptoms consistent with maxillary
sinusitis and recovering mild vestibular
neuronitis. Audiogram shows bilaterally
symmetric high frequency sensorineural hearing
loss consistent with age and without significant
change from previous exams. Thyroid function
tests were normal.
Eyes: No ocular pathology was noted on dilated
ophthalmoscopic examination. Visual fields were
normal. Distant visual acuity was 20/20.
Corrected near visual acuity was 20/20 in both
eyes (the President uses reading glasses as
needed). Intraocular pressures were normal
Neurologic exam: Comprehensive examination
Gastrointestinal: Normal. Colonoscopy was last
performed in July 2007. No recurrence of
previously described symptoms consistent with
occasional gastroesophageal reflux. Abdominal
Cardiology: Physical examination of the
circulatory system was normal. The resting EKG
revealed sinus bradycardia consistent with
previous exams and aerobic conditioning. Fasting
lipid panel: total cholesterol: 170 (last year
174; “desirable”<200); HDL: 51 (last year 60;
>40); LDL: 106 (last year 101; "optimal"<100,
“desirable”/“near optimal”<130); total
cholesterol/HDL ratio 3.3 (last year 2.9);
Triglycerides: 61 (last year 71; <150). hsCRP: <
0.012 (range 0.0-0.5). Homocysteine: 12.5 (range
The President underwent Balke protocol exercise
treadmill testing (ETT) with echocardiogram. He
exercised for a total of 25:01 minutes achieving
a maximum heart rate of 184 bpm with a 1-minute
recovery of 150 bpm (34 beat differential). No
signs or symptoms of cardiovascular pathology
were noted. Stress echocardiogram was normal.
Dermatology: Seborrheic keratoses and lesions
consistent with solar damage (e.g.
telangiectasias) noted as in past. History of
past actinic keratosis was noted but none
discovered on this exam.
Musculoskeletal: General musculoskeletal survey
Genitourinary System: Normal. PSA was 0.6
(normal < 4.0).
A standard battery of routine screening
laboratory tests was performed and was
The President remains in excellent health and is
“fit for duty”. All data suggest that he will
remain so for the duration of his Presidency.
Based on an overview of his examination and
history the following clinical diagnoses are
1. The President remains in the “superior”
fitness category for men his age (greater than
ninety-seventh percentile for 60-64 year-old
Low” to “very low” coronary artery disease
risk profile. Coronary artery disease (CAD)
"activity-marker" evaluation (including
C-reactive protein, homocysteine, and
lipids), and “functional” studies (exercise
treadmill test) stratify the President to a
“low” to “very low” coronary risk category.
Continued “therapeutic lifestyle measures”
(i.e. reduced intake of saturated fat and
cholesterol, regular physical activity, and
weight control) are appropriate.
Sinus bradycardia, asymptomatic,
non-pathologic, and consistent with a
History of vasovagal syncope without
pathology, sequelae, or recurrence.
2. History of vitreous floaters, infrequent,
nonpathologic, normal for age. Mild hyperopic
astigmatism/presbyopia, fully correctable.
3. Seasonal allergic rhinitis, well-controlled.
4. Serous otitis media and maxillary sinusitis
with mild viral vestibular neuronitis,
5. History of mild high frequency sensorineural
hearing loss unchanged from examinations.
6. History of gastroesophageal reflux without
7. History of colonic adenomas, removed 7/07.
Repeat colonoscopy indicated in 3 years.
9. History of activity-related musculoskeletal
injuries currently without symptoms limitations
10. Skin lesions consistent with solar damage.
Recommend continued sun-protection measures
(e.g. sunscreen, wide-brimmed hats, etc.)
Seborrheic keratoses—treatment not indicated nor
requested. History of early, localized Lyme
disease, treated without recurrence or sequelae.
Recommend standard precautions in endemic areas.