This year, I had the pleasure of being at the AOPA Pilot Protection Services booth at the largest and greatest airshow in the world, EAA AirVenture in Oshkosh, Wisconsin. To the members who stopped by, thanks for all of your support and for saying “Hey.” I was quite surprised at how many of you asked me questions concerning high blood pressure and what the FAA considers when you are receiving treatment.
Well, fellow members, high blood pressure no longer requires a special issuance! It is now one of the conditions aviation medical examiners can issue (CACI). When an airman (of any medical class) is placed on a blood pressure lowering medication, they should ground themselves for about one week to see if they develop any adverse side effects. Your AME is taught not to grant issuance of your medical certificate for at least 2 weeks after you start a new blood pressure lowering medication. Just about all antihypertensive medications are allowed by the FAA. The only category of medications the FAA doesn't accept is what is known as the centrally acting medications. An example of this type medication is Clonidine (trade name, Catapres).
To participate in the CACI program, you cannot be on more than three different categories of medications. You are to be free of any side effects of the medication(s). The blood pressure in the AME's office should not be higher than 155/95. If he or she cannot get a blood pressure reading lower than that, he or she cannot issue you a medical certificate.
It is advisable as an airman in this situation to obtain a letter from your treating physician that gives a brief history of the problem, lists the medications you are taking, comments about any side effects, gives a brief immediate family history, and has confirmation of two or three blood pressure readings that your physician got in the office. Having a listing of those blood pressures readings may save you from having the AME defer issuance when he or she cannot obtain a blood pressure reading lower than 155/95. If your application happens to be deferred, you will have to demonstrate control before the FAA grants you issuance.
So folks, high blood pressure is not a complicated medical condition in FAA civil aviation medicine these days!