Blood Pressure : What to Expect at the Flight Physical

I. Code of Federal Regulations

Legal References: 14 CFR 67.113(b)(c), 67.213(b)(c), 67.313(b)(c), 14 CFR 67.111, 67.211, and 67.311

Legal Extract (Applies to All Classes):

• No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -

  1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

  2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

• No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved finds -

1. Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or

2. May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.

Measurement of blood pressure is an essential part of the FAA medical certification examination. The average blood pressure while sitting should not exceed 155 mm mercury systolic and 95 mm mercury diastolic maximum pressure for all classes. A medical assessment is specified for all applicants who need or use antihypertensive medication to control blood pressure. (See Section III. B. below.)

II. Examination Techniques

In accordance with accepted clinical procedures, routine blood pressure should be taken with the applicant in the seated position. An applicant should not be denied or deferred first-, second-, or third-class certification unless subsequent recumbent blood pressure readings exceed those contained in this Guide. Any conditions that may adversely affect the validity of the blood pressure reading should be noted.

III. Aerospace Medical Disposition

1. Examining Options

   1. An applicant whose pressure does not exceed 155 mm mercury systolic and 95 mm mercury diastolic maximum pressure, who has not used antihypertensive medication for 30 days, and who is otherwise qualified should be issued a medical certificate by the Examiner.
   2. An applicant whose blood pressure is slightly elevated beyond the FAA specified limits, may, at the Examiner's discretion, have a series of 3 daily readings over a 7-day period. If the indication of hypertension remains, even if it is mild or intermittent, the Examiner should defer certification and transmit the application to the AMCD with a note of explanation. The Examiner must defer issuance of a medical certificate to any applicant whose hypertension has not been evaluated, who uses unacceptable medications, whose medical status is unclear, whose hypertension is uncontrolled, who manifests significant adverse effects of medication, or whose certification has previously been specifically reserved to the FAA.

2. Initial and Followup Evaluation for Hypertensives Under Treatment

   See Hypertension Worksheet (in the dispositions table, Item 36. Heart)