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Blood Pressure and Flying....

D

David-aviator

Well Known Member
My blood pressure as of about 10 minutes ago was 116/61, pulse 72.

That was not the case on November 3, when I visited my AME for a class III medical renewal. That day it was 160/100. I was in trouble, knew it and my doc was not happy. He suggested I come back in a few days for another check. He's had me on a BP pill for quite some time and it apparently was not working anymore.

I went back several times for a BP check with one of his assistants and while it was somewhat lower, he still was not happy. I decided to make a second appointment so I could talk to him about the "white coat" syndrome, thinking that was part of the problem. There also was a death in the family that week and I thought maybe that was a factor.

But I knew I was pulling at straws. I did a search on the internet for some advice on the subject. There is a ton of it - everything from slow breathing to herbal pills to some very basic advice, like stupid, get on an exercise program. (But I hate formal exercise and always have, it is so, so boring and wastes a lot of time.)

I opted to dust off our tread mill which had not been used for some time. I hate that machine with a passion but much to my surprise and delight, BP came down 10 points over night. All it takes is 20 or 30 minutes a day. I've rigged up a shelf to hold a lap top computer and kill the time watching great old favorite movies - like Piece of Cake for the umpteenth time.

When I showed up for the second AME appointment, the initial reading was 138/80 taken by a technician. I was nervous as heck as BP was up from 110/70 at home. I had to wait some 45 minutes for the Doc and knew I was on thin ice with him so I tried to relax, even took a short nap waiting in this cubicle. When he walked in, I showed him the readings from the previous several days at home, but what really cinched it was when he took a reading and it came in at 124/74. He was happy with a grin. So was I. And relieved. I had the medical certificate one more time.

I guess the point of this story is you're never to old to learn something new. Exercise does cure hypertension. I've been told that by Dr's but never believed it. It was easier to continue to hate the idea and look for some other reason and solution for the problem. Live and learn, or is it learn and live?

The bearings of the treadmill will need some oil, I've about decided to make it a permanent deal every day whenever possible. I do want to continue flying above all else. The way this thing is going, I may be able to get off the BP pill. The dose is reduced already and the pressure continues to fall.
 
FAR 67.3XX

I believe that there is no longer a specific BP requirement in FAR 67.3XX that covers Third Class certificates, or any other class of certificate for that matter. Correct me if I'm wrong.

Can an AME decline a certificate for high blood pressure under the General Medical Condition clause - 67.313(b)(1) "Makes the person unable to perform the duties....etc, etc."?

Having said that - congratulations, well done and keep it up :)

It's good all around to exercise - it increases strength and endurance, not to mention the mental health and overall productivity benefit of releasing all these natural endorphins into your brain. You just feel better.

I'm training to try and not embarrass myself at our local Turkey Trot on Thursday. However I still seem to get slower every year - I wonder why? Still it lets me enjoy thanksgiving dinner with less guilt :)

Jim Sharkey
 
jsharkey said:
I believe that there is no longer a specific BP requirement in FAR 67.3XX that covers Third Class certificates, or any other class of certificate for that matter. Correct me if I'm wrong.
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It is not covered in the FAR's. It's in the 2009 Guide for Medical Examiners, a copy of which can be down loaded from AOPA. It has plenty to say about hypertension. Here is an example -

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.

Hypertension medications are approved by the FAA but the AME must monitor the administration of the drugs for a specified time period to insure they do not have side effects that could affect a pilots ability to fly. It has not been a big deal for me.
 
Caffiene too

I am glad you re-discovered exercize. It will help in many ways other than just your blood pressure. It's all about being healthy, not just appearing so once every year or two... That being said:

The other thing to remember is that caffiene and other energy drinks (stimulants) will also raise your blood pressure. If you consume a small amount each morning you should skip it on the day of your exam. If you consume caffiene (or other stimulants) throughout the day ... well, you shouldnt. But if you just can't help yourself, tapering off it for several days prior to your exam will likely help with the blood pressure too.

Dave Leonard, M.D.
Ex-Navy Flight Surgeon
 
Being overweight is also a factor

My neighbor lost 40 pounds and his blood pressure returned to the normal range for his age. No more medication for him.
 
My observations.

Yes, exercise can help. Does not have to be a lot, some bicycling or treadmill every day helps significantly. And, knock off the alcholol for a while. I went to my regular doctor for a check up once after sharing a bottle of wine with the wife the night before. Not something I usually do. Not good for the BP measurement on that day. Also, dont just drive to the doctor's office and sit down for the BP cuff, even after sitting in the waiting room for a while, a higher than normal reading is assured. I try to get to the office about 40 munites prior to the appointment. Then I take a nice relaxing walk around the nearby park. Soothing waterways, birds chirping, leaves swaying in the wind, etc. Helps a lot.
 
David-aviator said:
It is not covered in the FAR's. It's in the 2009 Guide for Medical Examiners, a copy of which can be down loaded from AOPA. It has plenty to say about hypertension. Here is an example -

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.

Hypertension medications are approved by the FAA but the AME must monitor the administration of the drugs for a specified time period to insure they do not have side effects that could affect a pilots ability to fly. It has not been a big deal for me.
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Thanks for that reference.
Jim Sharkey
PS - Piece of Cake was a great TV series
 
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Another thing to help is cut down on sodium (salt) intake and cut out items with fructose (soda).

Roberta
 
For the past 1.5 years I have gone to the gym about 4 hrs a week, stopped eating after 9pm, drink the lowest calorie beer I can find (MGD 64), and have lost 15 pounds so far. Dr. visits have been good and I can finally get my aileron trim off full right when I fly solo. :D
 
Blue Pill

I've heard the little blue pill will lower BP........(viagra)
anybody try that? Does it work to lower a BP readings at the Doctors office?
 
Little Blue Pill

Well, Bob, you are going to open a can of worms (NPI) with that one. Yes, the little blue pill acts as what we call an "alpha adrenergic antagonist", and can drop the BP. In fact there are cases in which enthusiastic consumers, thinking that if one pill is good, three should be great, have had severe syncopes during certain strenuous exercise.
Best advice is to establish a sound, realistic diet and exercise regime for life, and, trite as it may sound these days, "see your doctor".
Tom Navar, M.D.
Former RV-8 QB
Quietly following from the sidelines.
 
David-aviator said:
I opted to dust off our tread mill which had not been used for some time. I hate that machine with a passion but much to my surprise and delight, BP came down 10 points over night. All it takes is 20 or 30 minutes a day. I've rigged up a shelf to hold a lap top computer and kill the time watching great old favorite movies - like Piece of Cake for the umpteenth time.
Click to expand...

I read this message just before going out running this morning, and thought about it during the run. Sometimes when I run, my thoughts go in strange directions, and this is what I thought today:

When you spend a little time doing exercise, you sweat. When you sweat, you lose salt and water. The salt and water have to come from somewhere. One of those places is your blood. Your blood volume goes down. With less blood, there will be slightly less pressure -- lower blood pressure.

That's what I think happened to lose 10 points of blood pressure from one session on the treadmill.

[Of course, another thing that happens during exercise, is that extra blood and oxygen go to the legs, heart, and lungs, so less goes to the brain, so any clever ideas you get while running may not neccessarily be as clever as they seemed at the time.]

Long term, the benefits of exercise are better than you temporary loss of blood volume. You actually become more fit and efficient, so the blood pressure comes down naturally.

My .02
 
Blood viscosity increases with dehydration?

Maybe Blood Pressure would increase as you sweat and the blood becomes thicker.
 
I had an instructor in the Air Force who routinely took a shot of Vodka before his physical to prevent the "high blood pressure alarms."

It worked until he got caught.

:eek:
 
I'm on blood pressure medication and my blood pressure with that assist falls within the prescribed limits. What are teh extra hoops I'll have to jump through when I go for my physical?

Thanks,

Bob
 
bhassel said:
I'm on blood pressure medication and my blood pressure with that assist falls within the prescribed limits. What are teh extra hoops I'll have to jump through when I go for my physical?

Thanks,

Bob
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You will need a letter from your doctor stating the medication your on is controlling your hypertension with no adverse effects. also he needs to include 3 recent blood pressure readings.

Make sure the medication your taking is on the faa approved list.
 
"When you spend a little time doing exercise, you sweat. When you sweat, you lose salt and water. The salt and water have to come from somewhere. One of those places is your blood. Your blood volume goes down. With less blood, there will be slightly less pressure -- lower blood pressure.

That's what I think happened to lose 10 points of blood pressure from one session on the treadmill.

[Of course, another thing that happens during exercise, is that extra blood and oxygen go to the legs, heart, and lungs, so less goes to the brain, so any clever ideas you get while running may not neccessarily be as clever as they seemed at the time.]"

Blood pressure is a complex system involving the heart, brain, kidneys and the vascular system and it goes up and down a lot depending on your activity at the moment. The kidneys are the main control center and try to keep the BP normal but "normal" can vary over time in a person. You can tweek it a bit short term but long term lower BP is the goal. We need to establish a long term lower Normal set point for the kidneys to target. This is to get past the Medical but more important to avoid the complications of High Blood pressure like heart failure and strokes.
 
Dr. letters

Hi I've been on BP meds for 7 yrs., mine is hereditary and smoking for 40 yrs didn't help. My AME doesn't require any notes of any kind from my personal Dr. I go in for my renewal and he checks me out and we talk and I get my medical certificate, period, simple and hasn't been any problem since the symptoms started. If meds control your HBP your good to go. heck this isn't something that is going to incompasitate you when flying, exercise, eat right, use BP meds if needed and don't worry about it. Not doing whats needed to correct the HBP problem is a problem, it is known as the silent killer, get it under 140/90 and the damage that is caused to the smallest blood vessels in your organs is stopped. Thats what the Dr. has told me and what I've learned investigating HBP. Gene
 
gbumga said:
Hi I've been on BP meds for 7 yrs., mine is hereditary and smoking for 40 yrs didn't help. My AME doesn't require any notes of any kind from my personal Dr. I go in for my renewal and he checks me out


My understanding was a letter was a requirement of the FAA not the AME. I received a letter from the FAA stating this would be required. APOA and EAA also said this was a requirement.

I hope your right it would make life a whole lot easier.
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FAA Requirement

Hey Guy's , I just went thru this my last medical , my BP was 145/93 and now it is 120/74 on med.
1. Your personal physician must stabilize your Blood Pressure (with accepted medication by FAA )
2.Your personal physician is required to take Three Blood Pressure readings over a period of time ( 1 or 2 weeks ? ) your BP should be stabilized without any side affects , record this ,sign it and give it to you.
3.You submit this letter to the FAA
4. Take your medical and pass it on medication ,good to go, to normal expiration date.

I received this letter from the FAA.

Dear Mr. Ross
Our review of your medical records has established that you are eligable for a third class medical certificate.
The certificate you noe hold is valid until the normal date of expiration.

At the time of your next FAA medical , please ask your AME to submit with the report of exmination a current report from your treating physician regarding your history of hypertension , to include periodic blood pressure readings , values for serum potassium (if on diuretic) and results of any other test deemed nessary. Specific mention must be made of the medications used, the dosage, and presence or absence of side effects. The examiner may issue a medical providing you are otherwise qualified.

This letter should be retained by you and taken to your AME at the time of the renewal of your FAA medical application.

You are cautioned to abide by Title 14 of the Code of Federal Regulations (CFR's) , section 61.53, relating to physical deficiency . Because of your hypertension and non-cardiac chest discomfort , operation of aircraft is prohibited at any time New Symptoms or adverse changes occur or if you experience side effects from or require a Change in medication .

Sincerly, Larry F. Wilson . M.D. Regional Flight Surgeon .

Piece of CAKE !
 
Although it may be an age-related requirement (I don't recall), the worksheet from the AOPA also required an EKG.

I just filled out the form, handed it to my MD, he filled in the BP readings and dates, stated what med I'm on and that it's working, and then did the EKG. When I went to the AME, he looked it over, took my pressure, said that he'd call my MD if he needed to review the EKG (he didn't) and filled out my medical. Took longer for the paperwork than the exam. :)
 
This is all new news to me

Well, I guess I've been flying with an illegal medical for the last 7 yrs. I've never been ask to do any of this letter stuff by my AME. And I suppose that the FAA will read this and yank my DRs. AME cert. and ground me. What a bunch of stuff, HBP doesn't cause a flight safety problem. Now I'm upset that I haven't followed the rules properly, guess I'll call the AME and see if he wants me to do this. Gene
 
Just a follow up on hypertension and a little exercise.

I called my Doc's office this morning and reported the average BP readings over the past 14 days as 125/78 in the morning and 116/68 at happy hour, would he go along with reducing the medication? His response was "absolutely", just keep recording what is going on.

Old geezers have a problem with elevated blood pressure - seems to go with the territory. The pills work, but so does the tread mill - and it doesn't take much of it to make a difference, at least not here. It would be nice to get rid of the pills, notwithstanding that they do work.

This has become a passion almost like beginning an airplane project. The FAA medical is a carrot on a stick. I've decided it is worth staying in shape for and that's not all bad. BP and weight are headed down and my wife thinks it is a wonderful effort - a lot less stress and time than building an airplane and maybe I can fly the one I have a little longer. :)

So you young guys take heed. No one stays young forever. Hypertension is for real in terms of the damage it can do on your system. One of my younger brothers cashed in his chips just last month after losing both kidneys and having a major heart attack some years back. He was not over weight but high blood pressure may have been the culprit that wiped out his kidneys. If you are not monitoring your BP, think about doing it. That meter creeps up ever so silently and the next thing you know, its done major damage.
 
Blood pressure

The ole white coat hypertension is doing its duty on you. First of all, make sure your home BP testing unit is functioning OK. Compare to someone who knows their BP. If its functioning normally then you are getting white coat hypertension. Once you get high BP in a medical office and the doc looks at you like "I can't believe you walked in here and didn't come in on a stretcher" it is going to be anxiety producing when it is tested again because you know you need a certain number. This is magnified big time when you have a pilot's license attached to the result.
If you do have high BP, exercise and diet (already mentioned) are definitely a must. Even without high BP exercise and diet is a must for a healthy lifestyle.
That being said, I have run marathons and bike about 5000-7000 miles a year and work out 3-4 times per week and guess what, I have prehypertension (130/80-140/90). My dad just had a triple bypass so I am not messing with this at all. Before going on the meds (which I may have to do) I started taking a supplement by BIO-SPEC called Cardioease along with their EPA/DHEA omega supplement. I am not kidding, my BP dropped about 15 systolic and about 10 diastolic. Just took my BP tonight and it was 122/73 same as when my AME took it. I am a believer in this stuff. The supplement has an herbal vasodilator in it and the EPA/DHEA boosts your HDL level (good cholesterol). As long as it keeps my BP down I will continue taking it. If the BP spikes I'll be the first guy at the MD's signing up for meds. Also, as a side note, there have been multiple studies done that demonstrate the cardioprotective qualities of red wine. You need no more than 4-6oz of a deep red wine to get enough of a compound known as Resveratrol that is good for your heart and vessels. Resveratrol is a very powerful antioxidant that doesn't lower your BP but it is thought to protect your vessels from the damaging effects of high BP and vessel inflammation. If you drink to much you negate the good effects. So no less than the above listed amount for cardiac benefits.
Good luck to you!
 
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aarvig said:
The ole white coat hypertension is doing its duty on you. First of all, make sure your home BP testing unit is functioning OK. Compare to someone who knows their BP. If its functioning normally then you are getting white coat hypertension.
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The BP accuracy has been verified in his office and "white coat" readings are a factor - some days. Physicians know that. The OMRON series of BP monitors are very accurate (plus or minus 3 points) and physicians generally do accept their findings. I have had normal readings in his office and at other times not. BP is not all that cut and dried or consistent.

Some people are genetically predisposed to hypertension, my Dr is one of them. He is skinny as a rail and has HBP. But most of us have it due to a life style not conducive to long life and self imposed stress.

My only point here is to bring that fact home to younger guys who are ignoring the issue. It is a problem in our affluent culture and can have serious health consequences beyond not being able to exercise the privileges of the FAA medical certificate.
 
David-aviator said:
Some people are genetically predisposed to hypertension, my Dr is one of them. He is skinny as a rail and has HBP. But most of us have it due to a life style not conducive to long life and self imposed stress.

My only point here is to bring that fact home to younger guys who are ignoring the issue. It is a problem in our affluent culture and can have serious health consequences beyond not being able to exercise the privileges of the FAA medical certificate.
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Amen to that. I am one of the blokes with prehypertension who lives a fairly healthy lifestyle. Primary hypertension they call it. I call it stress. You are right on with our lifestyles.
Thanks for bringing this issue to the forefront of our thoughts. Ignoring high BP is doing ourselves a total disservice especially when its so treatable and early intervention is absolutely critical. One of the big reasons medicals are not reissued is due to heart disease.
 
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