OT: High blood pressure!

[RScott]

A member of our builder's group, a fairly new pilot went for his second medical of his flying career & they came up with pretty high blood pressure. AME gave him 2 weeks to get it fixed & report back with documentation from his doctor.

What's the usual drill on this kind of thing? Do meds usually take the BP down pretty quickly, in time for him to get it fixed for his medical? How much of a hassle is he likely to get into with this? Weight, long working hours on a sedentary job, no exercise are factors he can deal with over the long term, but of course, he needs a quick fix.

[61Flyguy]

I would caution against a "quick fix" approach. Once you are on medication for high BP you are typically on it for life I was told. I was taking medication for marginally high BP and subsequently lowered my BP through diet and exercise (not one of 3 Drs. ever even suggested this approach!). My AME deferred my medical to the FAA. Convincing the FAA that my BP was truly OK without medication was not an easy task and required much documentation. I finally got my medical but with a stern warning from the FAA that I can expect the same treatment next time I go to renew.

As BP can vary greatly with each reading perhaps your friend can make sure he gets plenty of sleep and avoids cafeine and checks it on his own before going back for his medical. If it is still high he may have no other option other than going on medication (I think it only takes a week or so to reach optimum effectiveness) unless he can get it under control through diet and exercise before re-applying.

[apatti]

I find exercise has a pretty quick effect on my BP. Over the winter I often don't get as much exercise as I'd like and my BP will inch up over that time. When I do start exercising I find it falls within a week. Also, I find a very direct relation between BP and salt. If I drink water instead of soft drinks (which I tend to drink a lot), my BP drops. And, I am not one of those folks that salts everything. I virtually never add salt to any of my food at the table. Unfortunately, I eat out a lot and many restuaurants salt their food heavily. I try to remember to ask for no salt or light salt when I order.

This is one of those things that vary greatly between individuals. There is no way to tell if what has worked for me will work for you friend. Just some things to try... Obviously, your friend should check with his physician before attempting any sort of an exercise routine. I am not an MD, don't play one on TV, and didn't sleep in a Holiday Inn Express last night. So, what do I know...

[Jamie]

Ok, this is a fairly dumb question, but why does the FAA take such a tough stand on high blood pressure anyway? I can understand low blood pressure because it tends to cause people to pass out, especially if pulling G's.

[rv7boy]

I would recommend contacting both the AOPA and the EAA. The AOPA probably has a medical person who can offer advice immediately. The EAA has excellent physicians who volunteer their time to call pilots with medical questions. I have had excellent experiences with both (though not involving BP). I'm not sure if you are required to be a member of AOPA or EAA to get advice from them, but of course, I would also recommend your friend join both, especially if he is planning on building an RV. The AOPA web site has some excellent information about different medical conditions that affect pilots; again, that may be accessible only if you're a member.

All BP problems are not disqualifying, but as the previous poster said, there will probably be a lot of paperwork, and if he can get his blood pressure down without medicine, that should assure him a healthier life as well as a Class III medical.

I'm thinking your friend should consider NOT renewing his Class III medical before getting his BP under control. If this is just a small departure from normal then it may not be difficult to get it down through diet and exercise. Without knowing the specifics of his situation, it's difficult to say which path he should take.

The AME is just doing his job, but my opinion is that he should be willing to advise your friend as to remedial options he can take to control his BP. You didn't say if your friend has a regular family physician he goes to, but in my opinion, this is a good example why a person should have a regular family physician. Your friend should inform his physician that he's a pilot and that he would prefer controlling his overall health with minimum medications. That's just my opinion, and it might be worth two cents.

My Dad had two heart surgeries for replacement of the mitral valve, and I thought his flying days were over. It took a lot of tests and a lot of paperwork (and a lot of perseverance on his part) but he was issued a Class III medical every 6 months for several years, and he flew legally until he was 84 years old. He did have a period of almost a year after his first surgery at age 75 before he could be issued a Class III.

Good luck to your friend,
Don

[Brantel]

Take a look here:

http://www.faa.gov/licenses_certific...sion/index.cfm

This pretty much tells it the way it is with BP. Just mention BP medicine on the application and the FAA goes berzerk with the extra poo they want in addition to the norm.

If his BP is above the FAA max of 155/95 consistently, he needs to get this under control because the FAA max is not healthy.

The rules say that if you are identified as being outside the standard, then you must be on a documented and stable program showing that it is under control before you can be issued a certificate. Maybe this is what the examiner wanted him to go and get established.

A few years ago, my wife made me go to a family doctor and he found mild high BP so he started me on some medicine. Later I went to renew my medical and had to reveal this on the application. Of course the FAA went nuts again and would not allow a certificate until I proved all the requirements listed in the link above. Since then, I lost 50lbs and started exercising, BP is under control without medication. The last time I renewed my medical 1 year ago, I listed all of this on the application and the FAA never questioned it.

[rv7boy]

Originally Posted by Jamie

Ok, this is a fairly dumb question, but why does the FAA take such a tough stand on high blood pressure anyway? I can understand low blood pressure because it tends to cause people to pass out, especially if pulling G's.

I realize the AMA probably doesn't quote from Wikipedia, but here's a quote:

"Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure."

Seems to me pilots should not be allowed to fly if they have a good chance of having a stroke, heart attack, heart failure or an arterial aneurysm.

From Wiki

I'm not an MD either.

Don

[Brantel]

Originally Posted by rv7boy

"Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure."

Seems to me pilots should not be allowed to fly if they have a good chance of having a stroke, heart attack, heart failure or an arterial aneurysm.

There are tons of risk factors for lots of things that can incapacitate a pilot.

Lots of people die every day with these types of conditions that do not fit in the "risk factor" groups.

[RV6_flyer]

Originally Posted by Brantel

Take a look here:

http://www.faa.gov/licenses_certific...sion/index.cfm

Read Brian's link.

I have had hypertension and been treated for it since I was 21. I had to have a treadmill stress test to get my student license over 26 years ago. I go through all the steps above every two years. I have had a medical and pilots license for the past 25 years. Just got a 25 year member pin from AOPA. I am fifty years old.

My primary care doctor is a pilot, airplane owner, and also my FAA Medical Examiner. As such, any thing that could keep me from flying would require him to report it to the FAA. I still use him for all my medical issues (have not had any) as I do not want to fly if I am not fit to fly. I believe that he understands and will do everything that keeps me legal and medically safe to fly. He knows more about medical issues than I and I do not question his medical judgement.

[Randy Walls]

My BP dropped 20 points (both systolic and diastolic) after 30 min. a day on an eliptical exercise machine for two weeks. Try to avoid the medication route if you can.