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Hypertension

By Penny Giovanetti, D.O. Manager, Aerospace Medical Specialties Division
Source: FAA Safety Briefing Mar/Apr 2018

Definition

Hypertension (high blood pressure) is one of the most common conditions faced by airmen seeking medical certification. Blood pressure is the measurement of the force of the blood pushing against the walls of the arteries as the heart pumps blood. The measurement is presented as two numbers: the systolic (top number) over the diastolic
(bottom number) in millimeters of mercury (mmHg).

A doctor should not diagnose hypertension based on a single reading or at one point in time. However, at the time of your FAA exam, a single systolic reading higher than 155 or a diastolic reading higher than 95 will require your Aviation Medical Examiner (AME) to follow up.

Recently, the American College of Cardiology published new hypertension guidelines, as shown in the table below.

Frequently Asked Questions

I have hypertension, what should I do?

You should determine an appropriate treatment plan with your physician. Uncontrolled hypertension significantly increases your risk of stroke, heart attack, and other vascular diseases. It is also disqualifying for FAA medical certification.

Can I get treatment that is acceptable to the FAA?

Lifestyle changes such as weight loss, exercise, and a healthy diet are highly encouraged. Nearly all anti-hypertensive medications are acceptable to the FAA, including combinations of up to three medications. The one exception is the class of drugs known as “centrally acting” e.g., Catapres, but this class is generally avoided in current practice. More than three drugs will require a special issuance.

How long will it take to get my medical certificate?

If you meet all of the criteria listed in the Conditions AMEs Can Issue (CACI) worksheet, your AME can issue a medical certificate at the time of your exam. You can view that worksheet at https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/certification_ws/ or simply Google “FAA CACI Hypertension.” If you have any questions, call your AME or Regional Flight Surgeon.

Penny Giovanetti, D.O., received a bachelor’s degree from Stanford, a master’s in Environmental Health and Preventive Medicine from the University of Iowa and doctorate from Des Moines University. She completed a 27-year career as an Air Force flight surgeon. She is board certified in aerospace medicine, occupational medicine and physical medicine/rehabilitation. She is also a Fellow of the Aerospace Medical Association and a private pilot.