Eckstein, an internal medicine specialist who has treated McCain for 16 years, says there's no medical reason why McCain shouldn't be able to fulfill all the duties of president. Eckstein says McCain has "no evidence" of heart disease or other cardiovascular problems, has normal blood flow to his heart muscle and even walked the length of the Grand Canyon two years ago.
The records released Friday show that McCain stopped smoking in 1980 after smoking two packs a day for 25 years. The senator wrote about his youthful drinking exploits in his memoir Faith of My Fathers— including one episode where he fell through the screen door of a girlfriend's house after too many beers. Today, his alcohol intake is "very infrequent: two drinks per month," according to a note Eckstein made after McCain had a physical earlier this year.
Eckstein said in a press conference that he has advised McCain to decrease his salt intake, but said the senator does not have high blood pressure.
Cannon says three of McCain's risk factors are reasons for concern:
• Although McCain is at a healthy weight — 5 feet, 9 inches tall and 163 pounds — the senator's blood pressure, 134 over 84, qualifies him as a "prehypertensive." That's higher than ideal, but below the cutoff for high blood pressure, Cannon says.
• Eckstein said he recently doubled McCain's dose of a drug called hydrochlorothiazide to treat kidney stones. But Cannon notes that this drug is also a diuretic and is commonly used as a first-choice treatment for blood pressure. If McCain needs the diuretic for his blood pressure, that would increase his heart risk even more, Cannon says.
• Cannon says McCain's cholesterol should be lower, given the candidate's blood pressure. McCain's total cholesterol is 192 on a scale in which anything below 200 is considered healthy. His LDL, or "bad cholesterol," is 123, while his HDL, or "good cholesterol," is 42. According to national guidelines, a man with McCain's other risk factors should have LDL of less than 100 and, ideally, no more than 70, Cannon says.
McCain, who had been taking an anti-cholesterol drug called Vytorin, recently switched to another statin, called simvastatin, after studies raised concerns about Vytorin's effectiveness. Although McCain got good scores on a stress test, Cannon said the senator's high blood pressure and cholesterol are more important indicators of his risk of a heart attack.