With the Nevada primary upon us and South Carolina waiting in the wings, I thought I might as well run over Bloomberg's health summary too. Ya know, that republican billionaire supervillain that has invaded the party. His came out in Dec: 
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Bloomy's physician is an internist from Johns Hopkins, Dr. Stephen D Sisson. Though Dr. Sisson states BlooBloo has been seen at John Hopkins for years, he fails to state how long he has personally treated him. That info might be obtainable elsewhere but it's not here 2/
I only point this out cuz all the other candidate physicians establish the length of their doc/patient relationships. At the very least, Bloomberg's last physical was in July. Warren's was in Jan 2019. Sanders in December. Biden doesn't specify but the letter is dated mid Dec
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Dr. Sisson goes over Bloomberg's past medical history first. Most notably, he had cardiac stents placed in 2000 when he was 58, though we don't know in which coronary artery. That's a little young. The average age of heart attack in US men is 65. 4/
And before you go off on about how this wasn't a heart attack, please remember that a positive stress test means he was at very high risk for one, and that the damage caused by a heart attack can vary from almost non-existent to catastrophic 5/
Mike developed afib in 2018. As I've said in previous threads, afib is an abnormal heart rhythm causing disorganized beats. That this occurred 18 years after his first stent means he's likely been taking good care of himself, presuming he hasn't had any unlisted incidents 6/
Bloomberg has normal heart function, meaning his heart is pumping blood adequately with each beat. He's also on a blood thinner, most likely something similar to Eliquis which Biden is taking. Additionally, Bloomberg is on a beta blocker to control his heart rate 7/
One of the bigger issues with afib is that the heart can beat way too fast. Beta-blockers help control this by blocking receptors for adrenaline in your heart muscle. A slower heart rate lets the chambers fill and pump blood more efficiently. This can also help lower pressure 8/
Bloomer also takes a "medication to control his cholesterol." Maybe more than one? If you haven't noticed, Dr. Sisson isn't being very up front with which specific medications are prescribed. He does this again by saying Bloomberg is "treated for arthritis and heartburn." 9/
This is such a vague way to talk about medical treatment. He may not even be referring to meds. For all we know, Bloomberg does acupuncture for his heartburn and takes morphine for his joint pain. It just doesn't tell us much in a document that's meant to be comprehensive 10/
The third paragraph begins with another declarative: "Bloomberg is in great physical shape." Most notably, his last cardiac stress test was in July and normal. People generally don't get stress tests every year due to cost but Mike can obviously afford it. 11/
Here's another funny bit. Dr. Sisson states that Mikey has a "muscular BMI of 25.8." Even putting aside the fact that BMI is a very flawed measure of weight and fitness, A BMI of 25.8 is *technically* overweight. You heard it folks, "muscular" Mike Bloomberg is overweight 12/
For the curious, body adiposity index and waist-to-hip ratios are both more accurate tools for assessing obesity. TBH, I think the reason BMI is still commonly used is because of the headache that comes with standardizing yet another health measurement (waist circumference) 13/
The rest of his vitals including blood pressure and heart rate are normal.
We're then given lab results assuring us his kidney function, liver function,
and cholesterol levels are within normal ranges. Speaking of cholesterol, let's
play a game 14/
We're then given lab results assuring us his kidney function, liver function,
and cholesterol levels are within normal ranges. Speaking of cholesterol, let's
play a game 14/
WHO HAS THE BEST LIPID PROFILE?
Target ranges
Total cholesterol:< 200
HDL:> 45
LDL/HDL:< 2
HDL ratio:< 3.5
LDL:< 100 if low risk, <70 if high risk
Bernie, Biden, Bloomberg are all considered
high risk due to age + heart disease
Warren (<75 w/o heart disease) is low
risk 15/
Target ranges
Total cholesterol:< 200
HDL:> 45
LDL/HDL:< 2
HDL ratio:< 3.5
LDL:< 100 if low risk, <70 if high risk
Bernie, Biden, Bloomberg are all considered
high risk due to age + heart disease
Warren (<75 w/o heart disease) is low
risk 15/
Bernie
Total Chol: 117
LDL: 58
HDL: 32
LDL/HDL: 1.81
HDL Ratio: 3.6
Biden
Total Chol: 126
LDL: 69
HDL: 36
LDL/HDL: 1.91
HDL Ratio: 3.5
Bloomberg
Total Chol: 139
LDL: 66
HDL: 59
LDL/HDL: 1.12
HDL Ratio: 2.3
Warren
Total Chol:193
LDL: 88
HDL: 95
LDL/HDL: 0.93
HDL Ratio: 2.0
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Total Chol: 117
LDL: 58
HDL: 32
LDL/HDL: 1.81
HDL Ratio: 3.6
Biden
Total Chol: 126
LDL: 69
HDL: 36
LDL/HDL: 1.91
HDL Ratio: 3.5
Bloomberg
Total Chol: 139
LDL: 66
HDL: 59
LDL/HDL: 1.12
HDL Ratio: 2.3
Warren
Total Chol:193
LDL: 88
HDL: 95
LDL/HDL: 0.93
HDL Ratio: 2.0
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Cholesterol is a tricky beast to interpret. LDL (low density lipoprotein) is "bad" cholesterol which can cause injury to blood vessels. HDL (high density lipoprotein) is "good" cholesterol which can help protect from cardiovascular disease. 17/
The ratios between them can also help predict outcomes. Several studies have shown these ratios to be more accurate predictors than LDL alone. In the case of our candidates, Warren clearly has the best lipid profile, Bloomberg second, with Biden and Bernie about equal 18/
None of them are poorly controlled, but Biden and Bernie might benefit from increasing their HDL levels. As I stated before, that's more easily said than done. The lipoproteins you inherit from your parents have a massive effect on how well you control your cholesterol levels 19/
The best thing for low HDL levels is EXERCISE EXERCISE EXERCISE. And I mean cardiovascular exercise that gets your heart pumping. Anyway, that's enough of my soap box for now. Going back to the letter, Dr. Sisson concludes Bloomberg's medical summary with nothing but praise 20/
Bloomberg has no major health vices and is reportedly in "outstanding health." Of the 4 summaries discussed, Bloomberg's is just as sparse as Warren's but has a much more concerning health history that really feels glossed over. Both Biden and Bernie's are much more extensive 21/
TBH, this comes across as a form letter, as in a very carefully crafted template that has new values plugged in. There's nothing necessarily wrong with that as long as the letter itself is properly detailed, but there's a lot left unsaid here that could be significant. 22/
eg., What are his exact meds? Where were his stents placed?
Has he ever had CHF? Does he have a surgical history? My point is the letter is written to be both vague yet reassuring. I'm confident that all the information in the letter is accurate but there are clear omissions 23/
Has he ever had CHF? Does he have a surgical history? My point is the letter is written to be both vague yet reassuring. I'm confident that all the information in the letter is accurate but there are clear omissions 23/
Something else to stress is that serious injuries tend to compound damage with time. This makes the immediacy of events such as stent placement or a brain bleed a double edged sword. On one hand, a recent heart attack is VERY concerning. The first year post-MI is crucial 24/
At the same time. someone like Bloomberg has been walking around w/stents as a consequence of heart disease for 20+yrs. Afib also doesn't happen without reason. Whether by age or other causes of deterioration, the conduction pathway in Bloomberg and Biden's hearts are damaged 24/
Though rate controlled Afib on blood thinners is not a common cause of death, people also rarely have Afib by itself. The condition does increase one's risk for other forms of heart disease such as heart failure. All of this is compounded by the duration of the disease. 26/
If you asked me whether I prefer Bernie to have had his first heart attack and stents placed in his 70s or his 40s, I'd honestly lean towards in his 70s because that implies he'd have gone an additional 30+yrs with a well working heart without significant damage. 27/
As opposed to living another 30+ years after an MI with a damaged heart. The same goes for say Biden who had brain aneurysms decades ago. He's thankfully had no additional events since then but that doesn't mean his brain's blood circulation hasn't continued to deteriorate. 28/
To be clear though, I am not a cardiologist or a neurologist, I'm a general practitioner who is always open to being corrected by a specialist. I also haven't examined any of these people, so I can't speak beyond generalities. Every patient is different. 29/
If people are really that adamant about seeing the raw data for Bernie's tests (which I'd argue are not needed but I'm sympathetic with the desire to see them), should we ask the same of Bloomberg and Biden who have had heart issues for much longer? 30/
Do we need to see Biden's brain CT angiogram and MRI to make sure he doesn't have brain atrophy? There's definitely a point where the media and the public demand too much information. In comparing the letters, I think Bloomberg is the only one who really falls short 31/
Even so, his letter is fine. Not all drs are trustworthy, but there's a good reason we rely on them so much to evaluate people's health. I ask you to keep that in mind when litigating the health of these four. Take their dr's words at face value unless given a reason not to /32
And if you only kept reading this long through all these threads to find out who wins "the healthiest septuagenarian candidate" primary, it's Warren. Have fun with that 😋 33 END
Link to the original thread on Bernie. Warren and Biden links at at the end.
