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Q&A: Uncomplicated Hypertension

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

Q. I have a question pertaining to the current FAA protocol for issuing a medical certificate when the applicant has hypertension. I recall that several years ago the applicant had to submit to a "cardiac work-up" which I believe required a resting EKG and some lab work. I understand this process is no longer followed, and the AME can now issue the certificate if the applicant meets the baseline maximum blood pressure reading specified in the regulations. I believe a statement from the applicant's treating physician is also required attesting to the applicant's blood pressure readings and medication.

I'd appreciate clarification pertaining to the current protocol. Thank you.

A. Uncomplicated hypertension now falls under the program known as CACI (Conditions AMEs Can Issue). Both you and your AME can go to the online AME Guide, select CACI Certification Worksheets, and see exactly what the criteria are. No workup beyond that of good clinical standard of practice is required for initial certification. Simply meeting the baseline maximum blood pressure specified in the regulations (155/95 mmHg) does not exclude the diagnosis of hypertension. Readings in excess of 130/80 should be followed up with your primary care physician to see if treatment is recommended.

Send your questions to SafetyBriefing@faa.gov. They will be forwarded to the Aerospace Medical Certification Division, without your name, and the answer will be published in an upcoming issue of FAA Safety Briefing.

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 a 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.