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Barbara Bush so fiercely disliked President Donald Trump that she blamed him for what she called a heart attack and, by the end of her life, she no longer considered herself a Republican.

“I’d probably say no today,” she told USA Today’s Susan Page in an October 2017 interview on whether she was still a Republican.

Those were excerpts, released Wednesday, of an upcoming Bush biography by Page, who spoke with the former first lady extensively in the final months of her life. Bush died last April and her husband, 41st President George H.W. Bush, died in November.

The book, “The Matriarch,” detailed Barbara Bush’s long-standing dislike for Trump, which went back decades. In diary entries from the 1990s, which the former first lady made available to Page, she described Trump as “greedy, selfish, and ugly.” By 2016, she was “dismayed by the nation’s divisions and by the direction of the party she had worked for, and for so long.”

In one interview, she told Page: “I don’t understand why people are for” Trump. In another, she expressed “astonishment” that women could vote for Trump.

The former first lady suffered what she described as a heart attack in 2016, stemming from a long battle with congestive heart failure and chronic pulmonary disease. She blamed the episode on the nasty 2016 election cycle and Trump’s relentless bashing of her son, former Florida Gov. Jeb Bush, who ran for president in 2016 too. She told Page that “angst” contributed to the heart episode.

Bush was at first hesitant to have her son enter the race. If he had won, he would have been the third Bush president following her husband and her eldest son, 43rd President George W. Bush. But, as Page wrote, the former first lady was so alarmed by Trump, she eventually agreed that her son should seek office.

In 2016, the former first lady would vote for her son Jeb Bush for president in the general election, while her husband voted for 2016 Democratic presidential nominee Hillary Clinton. After Trump won, her husband called the president-elect to offer congratulations and Barbara Bush wrote in her diary that Trump “was very nice” in that conversation.

After originally drafting a funny letter to former President Bill Clinton having assumed he would join the “First Ladies Club,” as she wrote, Barbara Bush wrote first lady Melania Trump welcoming her into the cohort.

“Dear Mrs. Trump, The world thought I was writing this note to Bill Clinton. I am glad that I am not. I wanted to welcome you to the First Ladies very exclusive club,” she wrote. “My children were older and therefore I did not have the problems you do. Whatever you decide to do is your business and yours alone. Living in the White House is a joy and their only job is to make you happy. If you decide to stay in NYC that will be fine also. When you come to the White House let your son bring a friend. That is my unasked for advice. God Bless you.”

After Trump’s election a friend in Maine gave Barbara Bush a Trump countdown clock as a joke, the new biography details. The clock displayed how many days, hours, minutes and seconds remained in Trump’s term. The former first lady put it on a bedroom table, later bringing it to Houston. The clock was by her bedside until she died, Page wrote.

“I’m trying not to think about it,” Barbara Bush told Page in a 2017 interview just before the first anniversary of Trump’s election. “We’re a strong country, and I think it will all work out.”

Allan Smith

Allan Smith is a political reporter for NBC News.