FAA Disease Protocols-Hypertension Elevated Systolic or Diastolic Blood Pressure

Heart Conditions General Problem List Part 67 Index Go Find an AME Pilot Home

FlightPhysical.com will discuss Hypertension in sections. This will parallel the FAA's Instruction to AMEs concerning this common and serious problem.

• Introduction to Hypertension
• Measuring Blood Pressure
• Initial Discovery in Pilots
• Medications used by pilots
• Followup and Duration of waivers
• General Aeromedical Disposition

Measuring Blood Pressure
Blood pressure can be measured with the individual lying down, sitting, or standing. Regardless of the position, the blood pressure recording will always consist of two numbers written like a fraction with the top number called the systolic pressure and the bottom number called the diastolic pressure. In the example 120/80, the systolic pressure is 120 and the diastolic pressure is 80. These numbers are in units of "millimeters of mercury". (That means that a pressure of 120 is enough to support a column of mercury 120 millimeters high.) In the artery being measured, most commonly the upper arm, the systolic (heart contracting) pressure represents the peak pressure resulting from the contraction of the heart. Diastolic (heart relaxed) pressure represents the lowest pressure between contractions of the heart. Keep in mind that each of these numbers is typically from only a single heart beat and that the two numbers are from different heart beats.

Most doctors today believe that people who consistently run blood pressures higher than 140/90 are at increased risk for the complications noted above and should be considered for treatment. Indeed, by JNC7 guidelines, those with a systolic blood pressure in the 120–139 range or a diastolic blood pressure in the 80–89 mmHg range should be considered pre-hypertensive due to increased incidence of future symptomatic cardiovascular disease. Remember, however, that blood pressure is variable and occasional higher readings are expected, especially during exercise. It is a preponderance of readings above 140/90 that defines hypertension or above 120/80 that defines pre-hypertensive. Additionally be aware that FAA and AME examiner limits are not severe, however pilots should also be aware of the importance of using their current status to help protect their own health into the future.

OK, so you have Hypertension as defined by the FAA--what's next? Go to Aeromedical Disposition Instructions.

Click on links for the procedures for specific instructions on initial reporting, medication discussion and followup procedures:

• Initial
• Medications
• Followup and Duration

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