Foreign policy, the state of the American economy and immigration are among some of the large talking points of the 2016 presidential race.

As the American people come closer and closer to making their decision on who will be the leader of the country for the next four years, there is one issue they should keep in mind: Is this candidate going to survive four years in office?

To help answer that question, each campaign traditionally releases a sort of bill of health for their candidate. Usually written by each candidate’s personal physician, the letters detail the medical woes and wonders of each prospective figurehead.

Here’s a quick synopsis of the health of the current presidential front-runners: Donald Trump and Hillary Clinton.

Donald Trump

The Trump campaign has taken a rather bombastic approach to publicizing his health records. His letter, which was published in late 2015, described Trump’s health as “extraordinary” and his laboratory values as “astonishingly excellent.”

This letter was penned by Dr. Harold Bornstein, Trump’s personal physician since 1980. The letter said Trump lost more than 15 pounds in the past year and that he takes 81 milligrams of aspirin daily.

Aspirin is a blood-thinning medication commonly used as a preventative measure against heart attacks. Trump’s cardiovascular status, however, was described as “excellent.”

Trump also has no history of drinking alcohol or using tobacco products. Yes, you read that right.

“It’s surprising that Trump’s letter, which was written by a gastroenterologist, does not mention a screening test for colon cancer, which Trump would be eligible for based on his age over 50,” wrote Dr. Colleen Cagno, assistant professor of family medicine at the UA. “Also, Trump’s letter mentions weight loss but not a starting weight.”

Trump has never suffered any form of cancer nor has he ever had joint replacement surgery. His only operation consisted of an appendectomy, a procedure in which one’s appendix is removed, at age 10.

The letter was four paragraphs long and ended with the concluding statement, “If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.”

Hillary Clinton

The Clinton campaign released a letter in a similar fashion last summer detailing her medical history. Unlike the letter from the Trump campaign, however, it was far more specific and provided more insight into her medical status.

The letter was written by Dr. Lisa Bardack, internal medicine physician and Clinton’s personal physician since 2001.

“Mrs. Clinton is a healthy 67-year-old female who’s current medical condition include hypothyroidism and seasonal pollen allergies,” Bardack wrote. “Her past medical history was notable for a deep vein thrombosis in 1998 and 2009, an elbow fracture in 2009 and a concussion in 2012.”

Deep vein thrombosis is the formation of a blood clot in the deep veins of the body, most often occurring in the legs. If not treated, the clot can spread to the lungs and be fatal.

“The big risk of getting DVT occurs when taking long flights or long drives or extended periods of sitting down,” said Ket Verma, a recent UA medical school graduate. “Clinton also has a family history of a blood clot, as her father had a stroke. However, I don’t think that this is a major [concern] given that she is on a blood thinner. That being said, she needs to be on top of her care because she is constantly traveling.”

One thing that stuck out to Verma was that Clinton’s blood thinning medication was switched from Lovenox to Coumadin.

“She has to be very careful taking Coumadin, as there is a much greater risk of bleeding, especially if she suffers a fall” Verma said. “The only reason someone can’t take Lovenox is because of issues with their kidneys. However, her letter does not mention any such issues. … In addition, lots of medications, or even green vegetables, can interact with Coumadin, interfering with the drug.”

Because of this, Verma said Clinton needs to stay on top of monitoring her international normalized ratio levels, a test typically used to asses one’s response to Coumadin therapy.

Verma also said Clinton should be wary of osteoporosis, a condition affecting postmenopausal women that involves weak or brittle bones.

“At her age, she is also at a high risk of osteoporosis,” Verma said. “If she were to suffer a fall, she would be at a high risk of getting a fracture, such as in her hip.”

Bardack, however, wrote that Clinton is still in good health for the presidency.

“[Clinton] is in excellent physical condition and fit to serve as president of the United States,” Bardack wrote.

Clinton vs. Trump

While both candidates appear to be in good health, Cagno said she was surprised by the varying degree of information provided in each letter.

“Comparing the physician letters for Clinton and Trump, I am struck by the minimal amount of detail in the letter about Trump,” Cagno wrote. “It doesn’t even include specific lab results.”

She also said she believed there are some aspects health that both letters failed to address.

“[Clinton and Trump] are similar in age and have both demonstrated their stamina and endurance over this long campaign trail,” Cagno wrote. “It would be interesting to know more about their other wellness behaviors such as sleep patterns, which, I imagine, is challenging during the run up to the White House.”

Overall,she said even though both Clinton and Trump have few medical issues and are on minimal medications, predicting any future health issue is not always precise and there are no guarantees of any health conditions.

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