WASHINGTON (AP) — President Donald Trump had another medical exam on Tuesday, putting his health under renewed public scrutiny after he has worked to dismiss concerns over his age and stamina.

The 79-year-old president spent more than three hours at Walter Reed National Military Medical Center for what the White House described as preventive medical and dental checkups. It was Trump’s fourth publicly disclosed medical exam since he returned to office for a second term, and it comes as he tries to project strength ahead of midterm elections that will test his sway with voters.

In a social media post after the visit, Trump said that he had just finished his “6 month physical” and that “Everything checked out PERFECTLY.”

The White House did not immediately release a written report from Trump’s doctors.

For decades, administrations have released selected results from presidential physicals, offering the public a glimpse at the commander-in-chief’s health. But the results are filtered through the White House and must be approved by the president, raising questions about what the public does and doesn’t get to see.

Trump, a Republican, turns 80 next month and was the oldest person elected U.S. president. His immediate predecessor, President Joe Biden, a Democrat, was 82 when he left office, dropping out of the 2024 presidential race because of widespread concerns he was too old for the job.

A Washington Post/ABC News/Ipsos poll conducted in April found that less than half of U.S. adults think Trump has the mental sharpness or physical health to serve effectively as president.

“I think concern for the president’s physical health is probably at an all-time high, and I think advanced physical age is the No. 1 concern,” said Dr. Jeffrey Kuhlman, who served as a White House physician for more than a decade under Presidents Barack Obama, George W. Bush and Bill Clinton.

For a president of Trump’s age, a complete physical would be expected to include advanced heart testing, screening for common cancers and a cognitive assessmentalong with basics like height, weight and blood pressure, Kuhlman said.

The White House has not disclosed what the visit entailed but expressed confidence in what it will show.

“President Trump is the sharpest and most accessible President in American history who is working nonstop to solve problems and deliver on his promises, and he remains in excellent health,” White House spokesperson Davis Ingle said in a statement.

No law requiring presidents to disclose their medical records

In the weeks leading up to his visit, Trump has been saying he feels as good as he did five decades ago — even as he jokes about his fondness for fast food and his minimal exercise regimen. Yet he’s also sensitive to perceptions about his age, noting that he takes extra caution descending the steps from Air Force One to avoid headlines about a stumble.

There is no law requiring presidents to publicize their health records, and the degree of transparency has varied by administration. Trump’s past reports have been criticized for offering scant detail and for providing statistics that some medical experts have viewed with skepticism.

At public appearances, Trump is often seen wearing makeup to conceal bruising on his handswhich the White House attributes to handshaking and regular aspirin use. He has sometimes appeared drowsy during meetings and closed his eyes for long stretchesthough he denies having fallen asleep.

Trump often boasts of having “aced” cognitive tests while frequently deriding Biden, who faced questions about his mental acuity. Biden and his aides pushed back aggressively against doubts raised about his fitness for office.

Some of Trump’s previous physicals have included the Montreal Cognitive Assessmentused to screen for dementia and cognitive impairment. Trump’s physicians reported a score of 30 out of 30 for him at his 2018 and 20 25 checkups.

Yet critics have pointed to Trump’s meandering speeches and sometimes bellicose rhetoric as evidence of cognitive decline.

Last month, a statement from more than 30 neurologists, psychiatrists and other medical experts — who acknowledged they’ve never examined him — said Trump was mentally unfit to serve and warned of an “increasingly dangerous decline” in his behavior based on what they called “objectively observable signs of serious medical concern.″

“Any so-called medical professionals engaging in armchair diagnosis or false speculation for political purposes are clearly breaking the Hippocratic Oath they’ve sworn to,” Ingle said.

Just like any other patient, presidents get to choose what’s disclosed about their health, said Sara Rosenthal, a bioethicist at the University of Kentucky who studies presidential health. Questions about transparency have become more acute as America elects aging presidents like Trump and Biden, she said.

“I think we can expect very little disclosure about the true health status of any president unless they’re in perfect health,” said Rosenthal, who has suggested an independent medical organization to review and report on the health of the president and those in the line of succession.

‘Nothing should be hidden’

Trump’s first medical report in his second term was released last April. In July, he was diagnosed with chronic venous insufficiencya common condition in older adults that causes blood to pool in his veins. Photographs have shown the president with swollen feet, ankles and calves, described by the White House as a symptom of chronic venous insufficiency leading to “mild swelling” in his lower legs.

Following his last publicly disclosed exam, described as a routine follow-up last OctoberTrump’s physician issued a one-page summary saying the president was in “exceptional health” without divulging many specific results.

The frequency of Trump’s medical checkups is not uncommon for someone his age, according to S. Jay Olshansky of the University of Illinois-Chicago, who has studied the health of past presidents. It’s part of a strategy to catch problems while they’re still treatable, Olshansky said.

Olshansky says the public deserves to see more than White House medical summaries that “may be subject to editorial discretion.” Full, unredacted medical records should be made public, he said: “Nothing should be hidden.”

WASHINGTON (AP) — The U.S. military said Monday that it carried out “self-defense” strikes in southern Iran, including on missile launch sites and boats placing mines, even as President Donald Trump said on social media that negotiations with Tehran were “proceeding nicely.”

The strikes were done “to protect our troops from threats posed by Iranian forces,” but the military was “using restraint during the ongoing ceasefire,” Capt. Tim Hawkins, the spokesman for the U.S. military’s Central Command, said in a statement.

Further details were not immediately available, including more specifics on the threats from Iran and what this means for negotiations. There was no official response from Iran, which had sent its parliament speaker Mohammad Bagher Qalibaf to Qatar for negotiations over the possible deal with the U.S.

Qatar, which faced intense attacks from Iran during the war, holds billions of dollars in frozen Iranian funds.

In Iran, the news website Tabnak, believed to be close to former Revolutionary Guard chief Mohsen Rezaei, identified four dead Guard troops it said had been killed in American strikes on boats. Iranian state television separately reported blasts around Bandar Abbas, a city on the Strait of Hormuz home to a military port and a dual-use airport.

The strikes were the latest attacks to shake the weekslong ceasefire in the war. The Strait of Hormuz, through which a fifth of all crude oil and natural gas traded once passed, remains effectively in Iran’s chokehold, disrupting global energy markets.

Trump brings up recognition of Israel

Earlier, Trump said any agreement to end the Iran war should include a requirement for several additional countries, including Saudi Arabia and Pakistan, to join the Abraham Accordsthe U.S.-brokered agreements from Trump’s first term aimed at normalizing relations with Israel.

The proposal came as the emerging Iran deal faced criticism from fellow Republicans who favor a harder line on Iran, and it could add new diplomatic complications to the negotiations.

Trump pointed to Saudi Arabia and Qatar as countries that should “immediately” sign on. Bahrain and the United Arab Emirates became the first countries to join in 2020, diplomatically recognizing Israel.

He wrote that “after all the work done by the United States to try and pull this very complex puzzle together, it should be mandatory that all of these Countries, at a minimum, simultaneously, sign onto the Abraham Accords.”

Trump has long hoped Saudi Arabia would join. Saudi Arabia in particular has for decades called on Israel to return to its 1967 borders and allow the formation of a Palestinian nation with east Jerusalem as its capital. Israel’s conduct in the war against Hamas in the Gaza Strip also has alienated Gulf Arab states and the wider Muslim world as well.

Pakistan remains key mediator

Recognition of a Palestinian state also remains key for Pakistan, which is among the countries that do not have diplomatic relations with Israel.

Islamabad-based analyst Syed Mohammad Ali said Pakistan’s position on Israel remains unchanged despite Trump’s latest proposal.

The president said he brought up the Abraham Accords plan with leaders during negotiations on Saturday. He said he would accept “one or two” countries declining to sign, but said most should be willing. Egypt and Jordan already formally recognize Israel and have long-standing peace treaties. Turkey first recognized Israel in 1949.

Masood Khan, Pakistan’s former ambassador to the United States, said it remains to be seen how workable the proposal might be for the countries on Trump’s list.

“The invocation of the Abraham Accords at this stage gives an altogether new dimension to the diplomatic and mediatory processes because this issue was not on the agenda,” he said, pointing to the domestic pressure Trump is facing to strike a favorable deal.

Still, Khan said, “the diplomatic track is still working, and I believe Pakistan is very much at the center of it, supported by regional countries.”

It remains unclear when or how any deal with Iran might be completed. Trump suggested even Iran could eventually sign on to the accords, if an agreement is reached.

The accords are a series of diplomatic, economic and security agreements created with U.S. influence during Trump’s first term, which also saw Sudan, Morocco, and, more recently, Kazakhstanjoin.

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Ahmed reported from Islamabad. Associated Press writer Jon Gambrell in Dubai, United Arab Emirates, contributed to this report.