“President Trump continues to demonstrate excellent overall health,” Barbarella wrote in the letter. “His cardiac age-a validated measure of cardiovascular vitality via ECG-was found to be approximately 14 years younger than his chronological age. He continues to maintain a demanding daily schedule without restriction.”

The doctor also said Trump received a flu shot and updated COVID-19 booster shots in anticipation of upcoming foreign travel.

The letter concluded: “President Donald J. Trump remains in exceptional health, exhibiting strong cardiovascular, pulmonary, neurological, and physical performance.”