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Taking the Pressure Out of Hypertension

By Paul Engstrom, Aviation Writer and IFA Member

The pressure is on - high blood pressure, that is. And that spells big trouble at your next medical certification exam, right?

Actually, knowing before the exam that you're hypertensive, rather than finding out from the aviation medical examiner (AME), already puts you a step ahead of trouble because there's still time to correct the problem.

Also in your favor: high blood pressure is one of the simplest medical conditions to treat with or without medication, as experts have learned within the last two decades. Moreover, the Federal Aviation Administration authorizes private pilots' use of many nonsedating hypertension drugs, some of which are relatively new and very effective.

Finally, even if your blood pressure is slightly elevated during the physical exam, you won't automatically be denied certification, according to Dr. Philip Alper, an AME in Burlingame, California.

For one thing, Alper notes, the FAA allows considerable leeway if there's no evidence of heart disease. For another, it knows that some things, like rushing to the exam, caffeine, fatigue, or anxiety caused by the exam itself, can temporarily boost blood-pressure readings.

FAA guidelines allow for readings of up to 170/100. The first number, in millimeters of mercury, is systolic pressure, the pressure in blood vessels when the heart contracts. The second is diastolic pressure, when the heart relaxes.

Make no mistake: High blood pressure, a malady that afflicts one of every four American adults, can ground you. An especially scary fact is that about one-third of people with hypertension don't even know they have it, as symptoms often are absent.

But the good news is that lots of hypertensive pilots still fly. In 1999, for example, more than 24,000 third-class aviators taking medication for high blood pressure were certified to fly.

Here's how you can keep hypertension in check and, in the process, gain your AME's blessing:

  • Eliminate the most common causes of hypertension, including excess body weight, lack of exercise, smoking, stress, and processed foods, which tend to have lots of salt. Your long-term health, both in the air and on the ground, will benefit regardless.
  • Before the exam, get lots of sleep, don't drink coffee or consume stimulants of any kind, such as diet pills, and don't dash to the doctor's office. Try to relax.
  • Also before the exam, visit your personal physician for advice. He/she can monitor your blood pressure on several occasions and offer the readings to your AME as proof that, overall, they're within acceptable limits.

When he isn't flying, Paul Engstrom writes and edits in Sebastopol, Calif.

The information contained herein is meant for informational purposes only. Neither IFA, nor Paul Engstrom assume any responsibility or liability for events that occur due to actions you or others on your behalf take based on the information given in this article. You are proceeding at your own risk. It is strongly advised that you seek the opinion and advice of a qualified aviation medical examiner and appropriate medical physician for any medical needs you may have.