Hypertension Reprise

After I submitted my column for the last issue, our medical certification staff and I were discussing suggestions for my next piece.  We joked that high blood pressure-hypertension- should be a subject that we have covered enough times that we wouldn’t need to address it anytime soon.

The next day I alone received a half dozen calls from members who were anxious and concerned about their next FAA flight physicals because they were either just starting blood pressure meds or were experiencing a trend of increasing blood pressure and were fearful they would have to start medications. After my chagrin abated, I chose my next topic for the eNewsletter.  You are correct, we are going to review the FAA’s policy for medical certification for controlled hypertension!

First, the Federal Aviation Regulations (FARs) do not specifically address blood pressure anywhere in Part 67, Medical Standards and Certification.  As is the case for many medical conditions, the FAA establishes certification policy based upon the regulatory language in the FARs—language that is broad in the scope of interpretation.   

Part 67 is arranged by organ systems such as Ear, Nose, Throat, and equilibrium; Mental; Neurologic; Cardiovascularand General Medical Condition.  The general medical condition section is “catch all” that includes diabetes requiring insulin or oral medications, and “no other organic, functional, structural disease, defect, or limitation” that the FAA determines to be problematic for flight activities.  Hypertension is considered one of these “other” diseases.

The upper allowable blood pressure limits for issuance of any class of medical certificate is 155 systolic over 95 diastolic.  The numbers represent millimeters of mercury (mm Hg) as noted on the old sphygmomanometer cuff or more modern digital devices in use nowadays. The systolic pressure is a measure of the arterial pressure when your heart is beating (“systole”) while the diastolic pressure occurs in between beats (“diastole.”) 

The Centers for Disease Control and Prevention (CDC) and the American Heart Association (AHA) consider “normal” blood pressure to be less than 120/80.  “Prehypertension” suggests an “at risk for development of hypertension” when pressures are 120-139 over 80-89.  Hypertension is readings of 140 over 90 or higher.   Next time, we will get into the certification nuts and bolts, a relatively simple process by FAA measures, provided you have done your homework, are adequately treated, and you have the necessary paperwork with you when you see the aviation medical examiner.

Portrait of Gary Crump, AOPA's director of medical certification with a Cessna 182 Skylane at the National Aviation Community Center.
Frederick, MD USA
Gary Crump
Gary is the Director of AOPA’s Pilot Information Center Medical Certification Section and has spent the last 32 years assisting AOPA members. He is also a former Operating Room Technician, Professional Firefighter/Emergency Medical Technician, and has been a pilot since 1973.
Topics: Pilot Health and Medical Certification, Pilot Health and Medical Certification

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