2016 Presidential Candidate Medical History & Information

Speaker 1: Welcome back everybody. Hillary Clinton has returned to the campaign trail since nearly collapsing on Sunday. She's also releasing more medical records and her doctor says, quote, she is fit to serve and in excellent mental condition, end quote. We're also getting a first look at Donald Trump's medical records after his appearance on Dr. Oz. So his latest screening show that he is a bit overweight and he's also on cholesterol medication.

Speaker 2: I've got to say, as a doctor, who's my patient, they're good for a man of his age.

Donald Trump: I feel as good today as I did when I was 30.

Speaker 1: I bet he does. With all these reports telling enough about the health of our presidential candidates, joining us now to discuss, we welcome our medical contributor, Dr. Ali Kasraeian. Thank you so much for joining us today.

Speaker 3: Good to be here.

Speaker 1: Very interesting because you hear a lot about that candidates should release their tax records and now the conversation has shifted to candidates should release all of their health records as well. What are your thoughts on what should be public knowledge when selecting someone who would be the most powerful person on the planet?

Speaker 3: For me, this is both interesting and entertaining to see how the media is putting this information out there and how the public takes it in, because, classically and typically, your medical information is incredibly private. And for us in the medical world, there's a lot of legal implication in terms of how medical information is put out there. There's this thing called HIPAA. If we text, if we talk, if we share any kind of medical information, there are a lot of legal ramifications in terms of how that information is shared. So it's very interesting how the fact that people don't very openly and transparently share their medical information is now looked at very negatively. And the fact that how they share it is made open to interpretation of the content of that medical information.

Speaker 4: So does that mean the HIPAA laws are kind of relaxed when it comes to the presidential candidates [looking out?] the window?

Speaker 3: I'll tell you what... I think it changes because the implications of that medical information is profound. So with the case of Hillary Clinton, I think the challenges here exist in the fact that her known medical history and some of the things that have been put out there that we see as the viewing medical... Sorry, media... audience...

Speaker 5: I've seen so many things of her. There's actually multiple reports, if you go on social media, showing her collapse, showing her cough incessantly, showing... There's multiple... They show a whole diatribe...

Speaker 1: Isn't there a conspiracy theory that she's now traveling with a neurologist and she had a body double that day who came out? So do you think the lack of transparency then leads to some conspiracy?

Speaker 3: So that's the challenge with this. We do know some information with the fact that she has had a history of deep vein thrombosis. She's had some issues with blood clots in the brain. She is on Coumadin so that when you watch falls and balance issues, it brings forth a couple of real concerns where if someone that is on a blood thinner has falls... You worry about a fall and hitting your head and having a major blood brain bleed. And that for someone who is going to be leading our nation is very concerning because if she has a brain bleed and has a neurological impediment, that becomes very concerning.

Speaker 3: So I can see the reality in that concern, but now being that we see these things, and she had a big kind of neurological... A potential neurological issue that was witnessed this past weekend, which can be explained by dehydration. But with the fact that a lot of things were put out there over the past several months that maybe neurological and ideology, you can read things about talks of seizure disorder. You talk about dementia. You talk about Parkinson's disease and the lack of transparency fuels the fire, if you will. So that's one of the challenges that...

Speaker 6: But her husband has come out and said... He's had his moment in the spotlight of talking about her and saying that this has happened many times, frequently. Just a couple of time. Just a few times, that she's actually fainted due to dehydration. Could this really be the case?

Speaker 3: Well, dehydration can be an issue. And again, one of the things [inaudible]

Speaker 6: But over and over? You said it had to happen, but over and over...

Speaker 1: Well, one of the other things in the medical report was that she also has low blood pressure, unusually low blood pressure, and that can also lead to fainting spells as well.

Speaker 3: Those can happen, but again, it's concerning, if you are the viewing public and then you're are not getting information, again, that can fuel the fire. And again, as a medical professional, I have no information in terms of her actual medical reports. For me, as someone to come here and fuel the fire and say things is medically irresponsible for me to do that. So I believe that, as a viewing audience, we need to be skeptical of all the information we get, and as a medical professional, for us to comment, we have to have all the information, and correct information, before we make very, very absolute commentary, in turn, because there are implications for what we say. But, as a voting member of the American populace, you have to take this information because some of these things that may happen for someone who's on blood thinners and may have falls, that is important information, because that is profound.

Speaker 1: So we talked about Hillary and we've got to give equal time to Donald Trump coming out and saying that he's a little overweight and he's on some cholesterol medication. Are those areas of concern as well, as you mentioned, becoming for a leader in this position?

Speaker 3: They can be. The one thing I find interesting is no one was talking about anyone's health and now everyone is talking about everyone's health. So I think that's fairly interesting from that aspect of things. I think the points to take home from this aspect of things. He is probably going to start talking more and more about his health and then the voracity. I think the thing to take home from this, I hope, I wish them both well. I hope they both make implications of healthy choices and improved health from that [standpoint?] thing. I think someone being overweight is not necessarily a good thing, but hopefully this opens up a transparency that's true, not a falsified transparency that is for perceived value. But again, these are people with medical history and we have created in this electoral cycle one that I unfortunately believe creates a vein of mistrust that I hope we move away from. But, I think as a medical professional, I hope other medical professionals that make commentary in the media, we hold our comments to truths that are based on fact and medical information and not hearsay.

Speaker 1: Speaking of medical information, we want to move on to there's some new research about statins. Statins are a class of drug used to reduce cholesterol, specifically that bad cholesterol, called LDL or low density lipoprotein, within the body. Major review has recently found that the benefits provided by the drug and lives saved have been underestimated and the harms exaggerated. So, Dr. Ali, what does this mean for people taking statins now? It's a better thing than we thought.

Speaker 3: It's good news.

Speaker 1: Good news. All right. Next. Moving on. Exactly. How did it get to have such a bad reputation?

Speaker 5: I didn't even know what they were.

Speaker 3: So statins are a wonderful drug that historically was... Lipitor was a medication along with aspirin, which studies have shown actually saved lives. Cholestrol... Your good cholesterol is HDL, which if you have a high level of that, is good to have. And then you have the bad cholesterol, LDL, which, if that is high, is not good. It's bad plaques in your vessels, so it increases risk of heart attack, strokes, and things of that nature. So when your bad cholesterol is high, doctors will put you on a medicine to bring it down. Statins happen to be that. Over the recent past, studies that have come out and people were complaining of side effects, such as muscle pain.

Speaker 5: I was about to say, what are these exaggerated side effects?

Speaker 3: So people would have muscle aches. Liver function tests would go up. Some claims came out of things like hemorrhagic strokes, meaning that you had had a bleed in the brain and things of that nature. So what this study looked at a large...

Speaker 1: Disproved that?

Speaker 3: Yeah. It was a large number of patients that were followed for a long period of time, and they found actually that the benefits outweighed the risk. And so specifically they looked at people on 40 milligrams of Atorvastatin, which was one of the statins. Five-year period of time in 10,000 patients, and they found that it prevented a thousand people with a preexisting heart disease from having a major cardiovascular event, heart attack, stroke, or a cardiovascular... A coronary bypass procedure.

Speaker 6: That's pretty major.

Speaker 1: Yeah. A thousand people. That's awesome.

Speaker 3: Significant. So it's very good. And then if you didn't have a preexisting heart condition, 500 people were saved from having a heart attack, stroke or a bypass procedure. So it's pretty profound. And from one of the authors, Professor Rory Collins, he actually put it in a wonderful perspective. So in the UK, United Kingdom, for the 4 million people who had a previous heart attack and the 2 million people at an increased risk for having a heart attack, being on a statin prevented, or would prevent, 80,000 heart attacks. And so it would be prevented by being on a statin and only 600 people would get a myopathy, or muscle aches.

Speaker 4: So where do we go from here?

Speaker 3: So if you look at this stuff, it seems like the...

Speaker 5: I'd choose it if I needed it.

Speaker 3: Yeah, and the benefits far outweigh the risk associated with this. So, for being on a statin for every one millimole per liter of a decrease in LDL. So a small decrease in the LDL, the risk of dying of a heart attack and a stroke, or having a coronary procedure, is reduced by 25% for every year that you take it.

Speaker 5: Let me interrupt you and ask you this question. I said I would take it if I needed it. But one of the things that I found really interesting when I was taking a look at this, I said early on that, I didn't even know what statins were. And now, as I was reading it, it really talks about how your diet really could make a more profound impact than even taking a statin. Ihat would definitely be the route I would go, and first, especially, is that... How do doctors influence that kind of stuff? Is your job just to prescribe the medicine?

Speaker 3: Everyone starts with that, so the recommendation is generally for everyone who is at an increased risk for a cardiovascular event is a healthy diet, regular exercise, stopping smoking, and decreasing your alcohol intake. And that goes without saying for people who are on statins. For a lot of people, even if you are doing those things, it may not be enough. And for a significant amount of the population, they may have familial hypercholesterolemia, so you have an increased risk of having issues with regards to significant risk of cardiovascular disease, even if you're doing all of those things.

Speaker 1: Well, we have that. Before we go, we have some very interesting information to give everybody, for men diagnosed with early stage prostate cancer...

Speaker 3: Is prostate cancer one of those small [inaudible]

Speaker 1: You are always... This is very important to you and you always keep us very up to date on the latest. So talk to us about what this new episode is.

Speaker 3: So this has just dropped, September 14th. Very basic study. So we've been waiting for the study to come out in the New England Journal of Medicine. So it's actually a prospective study, which looked at active surveillance versus surgery versus radiation therapy. And it's found that a very, very small subset of patients, looking at more than 80,000 men diagnosed with prostate cancer for a profound period of time, more than 10 years, very few patients actually died of prostate cancer. That's profound. So if you catch this early, you monitor it closely, or have surgery, or have radiation therapy, you don't die of the disease. And then secondarily, of the people who underwent active surveillance, about half of them eventually fell out and needed treatment. However, those people actually did not die of their disease.

Speaker 3: They may have had more metastasis. They may have had more recurrences and they had a little bit more progression of their disease, but they could get treatment in terms of surgery and radiation therapy. So it's one of those things where it opened the door in terms of the fact that we can do studies like this. And the other thing is if you have prostate cancer, getting screened, getting monitored, getting the idea of that not everyone necessarily needs treatment is something that we can entertain and you can do active surveillance and you can get treatment at the right time, and you don't necessarily die of the disease, is a profound thing to think.

Speaker 6: Praise God.

Speaker 1: Dr. [inaudible], you've been very positive this show. We appreciate that. Right. So you're going to have even more information about this research on your weekend radio show, The conversation. Saturdays on WOKV from 5:00 to 6:00, but we are not quite done with Dr. Kazraeian. When we come back, we're going to be talking about sickle cell awareness month. So stay with us. We'll be right back.