Hypertension

Current Federal Aviation Regulations do not impose blood pressure limits for any class medical certificate; however, the FAA has established a policy by which persons with controlled blood pressure may be certified at any class of medical.

The FAA considers blood pressure controlled when the average sitting blood pressure does not exceed 155mm mercury systolic and 95mm mercury diastolic with or without medication. If the blood pressure is controlled and the required cardiovascular evaluation is provided at the time of examination, the aviation medical examiner may issue the medical certificate, as indicated in the revised Guide for Aviation Medical Examiners.

The FAA currently allows most FDA-approved anti-hypertension agents, 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.

At the time of the first application for medical certification after starting blood pressure medications, you should have available for the aviation medical examiner a current cardiovascular evaluation that includes:

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 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 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. If you don't have it, the examiner can hold the application for up to 10 working days to allow you to get the evaluation. Otherwise, the application will be deferred to the FAA without the reports, and it could take three months or longer before your medical certificate is issued.

When you do receive an eligibility letter from the FAA, it will probably ask only for a status report at the time of your next scheduled FAA physical examination. The report should include a summary of current medication and dosages and at least three blood pressure readings. Comments should also address the presence of any side effects and end-organ complications. The letter should instruct your AME to issue your renewal certificate, provided you are found otherwise qualified. Keep the letter for reference, and have it with you at the time of your next FAA physical examination.