Answers for Pilots

Calm down!

June 1, 1999

Don't feel pressured by a hypertension diagnosis

Does this sound like you or a pilot you know? You're 40-ish; you've been working hard at your career for 20 years or so, and it just keeps getting more stressful, not less. Your kids are reaching a not-so-tender age; you've put on a little extra weight; maybe you still smoke a cigarette now and then or just can't kick the salt-shaker habit. Your profile could be the harbinger of a hypertension diagnosis.

Hypertension is the subject of the questions most frequently asked of the medical experts on the AOPA Pilot Information Center. When indicated on your airman's medical certification, hypertension — or high blood pressure — is like a red cape to a bull for the FAA.

"Hypertension is one of the simplest problems to address," states Ruby Zecher, a member of AOPA's medical certification team. Yet its diagnosis often sets off a chain reaction of stress for the unknowing airman; his or her aviation medical examiner (AME); and ultimately, the FAA. What causes hypertension is not completely known. Medical research has identified some common reasons for elevated blood pressure — the long-term effects of stress, a diet high in salt, obesity, genetics, and a sedentary lifestyle. High caffeine intake and smoking have also been linked to hypertension.

And it's a sneaky condition. You may have no idea that you have high blood pressure until the day that you visit your AME for your medical recertification and he says, "Uh-oh." A blood pressure reading higher than 155/95 may result in your application being deferred to the FAA for review. If that happens, you could be grounded for up to 12 weeks.

A call to the AOPA Pilot Information Center can help. Zecher and the other members of the medical team strongly recommend this simple avoidance procedure: See your family physician prior to your medical recertification exam. Traditionally, an AME is required only to view the basics of your health, the high points that the FAA deems important to the safety of pilots and others in the sky with them. If your regular physician can identify hypertension prior to your medical, he can help you to be prepared for your AME. First, says Zecher, your physician will recommend steps to bring your blood pressure down, such as changing your eating habits, reducing stress, or taking medication. He can monitor your blood pressure over several visits. Three lower-than-155/95 readings charted by your doctor can be presented to your AME as proof that your blood pressure is under control. Often the stress of a medical exam can result in what is referred to as "white-coat syndrome" in which your blood pressure is elevated during your medical. Presenting your AME with three acceptable readings can demonstrate that, despite an unusually high reading on that day, you have normal blood pressure.

Your physician may prescribe medication for your hypertension. Nearly all FDA-approved medications for hypertension are considered acceptable by the FAA for pilots' use, according to the amended Guide for Aviation Medical Examiners. Once again, if you approach your AME with proof of successful treatment for your condition, your recertification should be a breeze.

If you call the AOPA Pilot Information Center prior to your medical, the team can send to you and your AME a copy of the FAA certification policy concerning blood pressure limits for any class of medical certificate.

This be-prepared attitude paid off for Gary Peterson, AOPA 1229274. Peterson, 55, and a friend purchased a 1979 Grumman Cheetah and Peterson called the AOPA Pilot Information Center to get help for recertification. Zecher detailed all of the information that he needed, but a series of misunderstandings almost kept Peterson from getting his medical. First the FAA indicated to Peterson he needed to take a thallium treadmill stress test. Peterson's doctor questioned why the FAA wanted this particular test — at $1,400 it still produced results that were wrong 25 percent of the time, he said. Zecher discovered that the FAA had indeed sent Peterson the wrong request; he needed a regular treadmill stress test. He passed, but six months later, since all this wrangling had taken so long, it was time to get recertified again.

"Ruby called the FAA and I faxed things in. Within 48 hours I had my acknowledgement and could fly. AOPA helped me right away," said Peterson.

Complete information is in the Pilot's Guide to Medical Certification, available by calling the center or on the AOPA Web site ( If you do have problems and face losing your medical, you may obtain assistance through the AOPA Legal Services Plan (800/872-2672), and any interpretations of medical issues can be addressed by the specialists on the AOPA Pilot Information Center (800/872-2672).

As an AOPA member, you have access to the best source anywhere for information and answers for pilots. The AOPA Pilot Information Center gives you direct access to specialists in every area of aviation. The center, 800/USA-AOPA (800/872-2672), is available to members from 8:30 a.m. to 6 p.m. Eastern time, Monday through Friday. Information is also available on the Web ( . The AOPA Pilot Information Center, 800/USA-AOPA (800/872-2672), is available to members from 8:30 a.m. to 6 p.m. Eastern time, Monday through Friday.

Julie Walker

Julie Summers Walker | AOPA Senior Features Editor

AOPA Senior Features Editor Julie Summers Walker joined AOPA in 1998. She is a student pilot still working toward her solo.