And that's before he announced he would need a fourth surgery for a cancer first diagnosed in mid-2011.
Candidates of the governing Unity Socialist Party of Venezuela have campaigned on strengthening communes, which are grass-roots citizen councils that receive their funding directly from the central government.
It's a mechanism that has allowed Chavez to bypass state and municipal control and build loyalty, or dependency, opponents say, among the working poor through government goods and services they never had before. Free health care, subsidized food and access to free education have proliferated under the system.
If the Chavistas gain or even hold steady Sunday, the executive branch could strengthen its hold on the grass roots, as communal councils decide, often based on loyalty, such questions as who gets a new roof, or who receives vocational training, distributing the funds directly.
"The idea is a gigantic state that controls everything," said Angel Alvarez, a political scientist at Venezuela's Central University.
Chavez, 58, underwent six hours of surgery in Havana on Tuesday that government officials said involved bleeding, which was stanched, and would mean a difficult recovery.
Analysts say his absence during campaigning could hurt Chavista candidates in Sunday's elections, especially relative newcomers who in the past could count on the president accompanying them on the hustings.
Government officials have been doing their best to compensate.
They have been holding vigils for Chavez all week, hanging banners in tribute and broadcasting elegiac footage on state TV of the former army lieutenant colonel who first gained celebrity by leading a failed 1992 coup.
Capriles complained this week of the government using Chavez's failing health for political leverage, citing Jaua's statement that "people should vote Sunday for the president's recuperation."
"The leadership of a single person is not transferrable," Capriles told reporters.
Smilde, for one, expects whomever the Chavistas choose as their candidate to win any presidential election that would be called if Chavez, who is due to be inaugurated Jan. 10, dies in the next few months.
After that, many analysts believe the country could slide into economic turmoil as a fiscal hangover bites from Chavez's huge social spending last year. By law, presidential elections must be called if Chavez dies in the first four years of his six-year term.
Opposition congressman Julio Borges, who leads the Primero Justicia party, called Sunday's elections "just another piece on the chessboard of a country that is going to suffer very profound changes in the coming months."
He predicted a split electoral map, which he called the beginning of the end of Chavismo as "the president is going to be disappearing from the scene little by little."
In addition to choosing state governors, voters will also be selecting 229 members of state legislative councils.
Francisco Sanchez, a 45-year-old refrigerator salesman, said he hoped the opposition would have an edge Sunday as Chavez's one-man rule ebbs. But he fears divisions within it.
"We must remember that the only thing that unites the opposition parties is their desire to get rid of Chavez," he said.
Associated Press writers Chris Toothaker and Ian James in Caracas and Frank Bajak in Bogota, Colombia, contributed to this report.