High Blood Pressure: Don't Blow Your Top

High blood pressure or hypertension is common. The CDC reports that nearly half of all adults have hypertension. That’s defined as a peak (systolic) pressure greater than 130 mm Hg (millimeters of mercury, the unit used to measure and report blood pressure) or a minimum (diastolic) pressure greater than 80 mm Hg. Blood pressure is the pressure of the blood that is pumped by your heart into the arteries of your body. As you might guess too high a pressure is bad for your arteries, which means it’s bad for you. Sustained, untreated high blood pressure puts you at risk for heart attack or stroke. It can frequently screw up the arteries in the eyes or kidneys causing problems in those organs.

So how do you deal with this common but serious health problem? First of all you have to find out if you have it. If you go in for regular physical examinations, your doc usually checks it. A lot of pharmacies and health fairs will have machines or even people that can check pressures. If your pressure is elevated you definitely should get it treated. Your doc will probably want to check pressure a few times just to make sure it isn’t a fluke. If it’s consistently up there, she’ll want to treat it. The good news is that there are a number of quite well-tolerated medicines’ available to lower blood pressure. They cause few side-effects and are safe for long-term usage.

So how does the FAA handle pilots who have high blood pressure? First of all make sure you don’t have bad, untreated high blood pressure before you go in for your flight physical. If your systolic blood pressure is greater than 155 mm Hg or your diastolic pressure is greater than 95 mm Hg your AME will not be able to issue you a medical certificate. She’ll have to defer you to the FAA’s medical division. They’ll probably want some studies to determine if you’ve torn up any internal organs. They definitely will want to see you on an acceptable medication program. You’ll need a note from your doc that your blood pressure has come under good control and that you have no complications. Your Letter of Deferral from the FAA will detail all the hoops that you will have to jump through.

You can avoid all of this hassle, however, by getting your blood pressure under control before you go in for your flight physical. The FAA recognizes that most airmen can achieve good blood pressure control with good medications. If that is the case your AME can issue a medical certificate on the spot through a CACI. That is a “Conditions an AME Can Issue.” It is a program the FAA set up several years ago to allow guys with a variety of medical conditions that are well controlled to get their medical certificates without going through an FAA review. Each CACI condition has a fairly simple check list that your AME can go through. If all the answers are all favorable, she can issue on the spot.

For hypertension here are the CACI conditions:

• Either your doc or the AME must find that the condition is stable for at least 7 days.

• You cannot have any symptoms from your hypertension or the medicines you are taking for it.

• Blood pressure must be less than 155 systolic and 95 diastolic. Mind, you want it at or below 130/80, but the FAA recognizes a flight physical is scary!

• You can be treated with up to three of the following groups of anti-hypertensive medicines: Alpha blockers, beta blockers, calcium channel blockers, diuretics, ACE inhibitors, ARBs, direct renin inhibitors and/or direct vasodilators. Ask your doc which category the pills she’s giving you fall into. Better yet bring a copy of the CACI worksheet in for your visit (https://www.faa.gov/ame_guide/media/CACI_Hypertension.pdf).

If all of the above is true, you’ll get your medical certificate on the spot!

Fly wisely. See you next month!