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Despite the canceled trips, Mr. Putin is still shown on state television almost daily — mostly sitting at meetings with officials.

A Moscow-based political analyst said the health problems of Russian leaders in the past often have led to political crises.

“First of all, it slows everything down. Even the most immediate problems or solutions cannot be taken, and they have to be delayed,” said Viktor Kremenyuk of the U.S.-Canada Institute. “There is no mechanism to replace the president in the absence of the president. This simply means a standstill — everything stops.”

Mr. Putin’s macho image is especially important in Russia, which often has been ruled by aged autocrats whose health was routinely kept a top secret.

Russians often ascribed Boris Yeltsin’s disjointed speech and bizarre behavior to heavy drinking, although his press service insisted he was taking strong drugs to alleviate a heart condition.

Soviet dissidents once ridiculed the mumbling and senility of Leonid Brezhnev, who led the Soviet Union until his death in 1982 at age 76. Two more aged Soviet helmsmen died after Brezhnev in just three years before Mikhail Gorbachev took over in 1985 — prompting Russians to joke about “season tickets” to their funerals.

Dictator Josef Stalin’s death in 1953 came as a surprise to average Soviet citizens although his health had been deteriorating for years.

Mansur Mirovalev contributed to this report.