Answers for Pilots: Blood pressure

Flying by the numbers

February 1, 2011

Hypertension and your medicalIn the United States, 74 million people—one out of three adults—have been diagnosed with hypertension (high blood pressure). The causes are almost as diverse as the individuals affected: age, race, weight, and lifestyle top the list. Pilots, unfortunately, don’t escape the statistics, and an airman with uncontrolled hypertension may have a problem at the next FAA medical exam. FAA policy requires aviation medical examiners (AMEs) to defer applicants whose blood pressure exceeds 155/95.

Hypertension, however, doesn’t have to ground you. FAA has a long-standing policy allowing airmen with controlled hypertension to be certified for any class of medical. FAA allows most blood pressure medications including diuretics, angiotensin converting enzyme (ACE) inhibitors, alpha-adrenergic blocking agents, beta-adrenergic blocking agents, calcium channel blocking agents, direct vasodilators, or combinations of these agents.

When you visit your AME for the first time after being diagnosed and treated for hypertension, bring a current hypertension evaluation with you and the AME may issue your medical certificate in the office. The evaluation should include:

  1. A report of pertinent personal and family history, including an assessment of risk factors for coronary heart disease; a clinical examination that includes at least three blood pressure readings; a summary of medications and dosages; and statements regarding any side effects. Your cardiovascular doctor can complete the Hypertension Evaluation Worksheet to fulfill this part of the evaluation.
  2. A resting electrocardiogram (done within the preceding six months).
  3. A current (within the preceding 90 days) laboratory report of fasting plasma glucose, blood lipids, including total cholesterol, HDL and LDL, triglycerides. If diuretics are being taken, potassium and creatinine levels are also required.

The AME has to have the completed evaluation at the time of the FAA physical examination in order to issue a certificate. If you don't bring it, the examiner can hold the application for up to 10 working days to allow you to get the information. Otherwise, the application will have to be deferred to the FAA without the reports, resulting in a substantial delay (up to a few months) in issuing your medical certificate.
If your medical certificate has been, or if you think it may be, deferred, AOPA offers individual assistance through the Medical Services Program. If you enroll in the program, medical certification specialists will review your medical records as they pertain to your FAA medical certificate and act as your advocate with the FAA. AOPA’s medical certification specialists are in regular contact with FAA aeromedical reviewers and can help track the progress of your medical certificate application. You can enroll online or call AOPA to sign up, 800-USA-AOPA (872-2672).

For more information on how hypertension affects airman medical certification, watch this segment of AOPA Live, as Gary Crump, AOPA’s Director of Medical Certification discusses “ Hypertension and your Medical.” And, as always, if you have questions, give AOPA a call Monday through Friday, 8:30 – 6:00 Eastern Time, 800-USA-AOPA (872-2672).