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3rd Class Medical Question re blood pressure

W

wintaki

Member
Anyone know what the limit is for blood pressure to get a 3rd class medical issued?

I need to renew mine and unfortunately have gained some wait the last couple of years and my pressure is back up about 135/88 (had same some years ago before I dropped several pounds, it went down, and now is back up with weight gain again...)

I know I need to get it down and drop the weight for my own good, but I don't want any problems with my medical.

Any info appreciated, thanks,

--wayne
 
IIRC........

.......the max is around 190/85 or thereabouts. The other problem is the "White coat" syndrome. You start worrying about your high blood pressure and it gets higher the closer you get to the Doctor's office.

Regards,
 
You might go "pop"...

pierre smith said:
.......the max is around 190/85 or thereabouts. The other problem is the "White coat" syndrome. You start worrying about your high blood pressure and it gets higher the closer you get to the Doctor's office.

Regards,
Click to expand...

...with Pierre's numbers....:)

A good doctor will take a second set of readings at the end of your examination when you are more relaxed and the "white coat syndrome" has subsided....:)

My last two AMEs worked that way, and my regular GP.
 
I went for years with higher than normal BP because I was afraid that it would affect my medical status. I blamed it on "white coat" syndrome of course, even though I knew that hypertension was pretty much the thing in my genes. I finally got to the point where I simply couldn't ignore it, and confessed to one of my favorite Flight Surgeons. He proceeded to call me an idiot....he said that the FAA didn't care if I was hypertensive, as long as it was controlled! I got on medication, had a stress test, a few months of checks, and it never slowed my flying down. I feel more relaxed, and healthier, and at a lot lower risk for strokes and other really nasty things (a friend of mine had a stroke at age 49, and he's pretty much disabled for life - think about it!).

So....most people who know me know that I rarely give "advice" - but if you are borderline high on BP, get it fixed (in consultation with a good AME or Flight Surgeon), and then move on!

Paul
 
I had no problem getting BP under control W/meds

Hi, My Dr. said that 140/90 is the high #'s, if I remember right. I had a lot higher than that and w/meds it's 120/60 on good days. No special cert. just get it under control BEFORE you go to the AME ! I just cut out all junk food and fast walk for 30 to 40 minutes 6 days a week, take the meds and your ok to go. That also lowered my colesterol to 140 from 230. 190+ to 170 lbs. and I feel great have energy and younger woman follow me around in the store now, honest I think one was stalking me. Also now I can put a full classic interior in instead of hauling fat around. Gene
 
Take Paul's advice, get it fixed now!

There are too many good drugs for this! Too many risk associated with long term high BP.

The FAA would much rather you be flying with controlled BP than flying with uncontrolled BP.

Yes they want more test etc. but once you satisfy their initial demands, all you need to do is keep it in check and keep taking your meds.

The absolute worse thing you can do is nothing and later have a more serious issue ground you for good!
 
I couple things you can do prior to your exam that my Flight Surgeon advised was to avoid coffee, or anything with caffeine for that matter, 24 hours prior to your exam. Also, deep breathing excersizes prior to the exam while you are in the waiting room will help lower your BP a few points. As you know, loosing some weight will also help in more ways than one. Good luck!
 
I found that my blood pressure is always higher in the morning than later in the day. I always schedule any doctors appointments in the afternoon when possible because it makes a difference. I have checked my blood pressure several times a day for several weeks and verified this. I do take medicine for high blood pressure and it keeps it controlled. It seems the more I do to lower my blood pressure before the doctors visit the higher it will be. I don't change my routine in any way and that seems to work the best for me. Everyone is different so you have to find what works for you.
 
With my physical day after tomorrow, I have been checking things out--new glasses and BP checks, just to make sure. I had crept up to around 142/74 at the first of the year. With white coat, that could jump to over the limit. Started exercising and in two weeks lowered it to 124/64. I feel good about that. One guy in our EAA chapter lowered his from 190/100 to 130/80 in four months of working out. Also lost lots of weight/waist.

Bob Kelly
 
No set BP limit

There isn't a hard and fast limit on BP. Here is a quote from the AOPA:

"Current Federal Aviation Regulations do not impose blood pressure limits for any class medical certificate; however, the FAA has a long-standing policy by which persons with controlled blood pressure may be certified at any class of medical.

The FAA considers blood pressure controlled when the average sitting blood pressure does not exceed 155mm mercury systolic and 95mm mercury diastolic with or without medication."

For the last few years I've gone in for a physical with my doctor a couple of months before I go in for my fight physical just to catch anything before hand. Sure enough, my BP was border line high a couple of years ago so they put me on an ACE inhibitor (Benzapril). It got it under control in no time. The only thing that I had to do for the FAA was to provide them with 3 BP readings. I did all this BEFORE I even stepped into the medical examiner's office. I had my doctor write a quick note explaining what I was on, the dose, and my BP readings. I flew through with no problem.

I got a letter from the FAA that said I was good to go for the rest of the medicals but I forgot about that letter so I simply provided them with 3 BP readings again just to be safe. Once again, no problem.

Get the BP under control. The longer it's under control, the less damage it can do. The medication that I take is a non issue and it works very well.
 
Last edited:
Blood pressure

For the last five years or so I was getting borderline with BP in the range of 140/85. It is for the most part genetic, but I could also stand to lose about 10 lbs. Mid 50's. My last medical clocked me in at 150/90, and the Doc indicated he worked with 155/95 (if either of those go high) as max. I passed but felt uneasy about letting it go another couple years. My GP prescribed a low dose ACE inhibitor which dropped it 15 points and I now have less worries. If you have ever been into the FAA or AOPA website to look for approved meds, there are many. I am sure your Doctor and you can match something up.
 
I have been taking medication for high blood pressure since I was 21. I will turn 52 this year. I have had a VALID medical certificate since I passed my check ride on my 25th birthday.

The FAA has known about it since day one. Listen to the above advice in all the posts before mine about getting treatment. Talk with AOPA on what the FAA wants. Make sure that all the info the FAA wants is in hand at your physical and gets forwarded to OK City with your application.
 
We see too many post that are giving advice on how to hide or cover up high BP. High BP is high BP and no matter what, your body is being trashed by the effects of it.

All the little tricks to get by a physical do nothing but delay the inevitable and the worse part is damaging your body in the meantime. Its the average that counts, not a one time reading or many readings taken under the best of circumstances or the best time of day after listening to soothing music.

The FAA max for BP is way to high... Just ask any doctor that treats BP.

BP...Get it checked often, if high get it under control, document it, report it on your next physical, jump a couple FAA hoops, live long and prosper while flying!
 
Treat the hypertension

First of all, let's clear up the definition of hypertension. It is defined as systolic/diastolic pressures in MM of Hg of greater than 140/90.

Left untreated, it can cause a lot of problems such left ventricular hypertrophy (enlargement of the left side of the heart) and CHF (congestive heart failure). Your optomitrist can even tell if you have been hypertensive for extended period by looking at the blook vessels in your eye and seeing a condition known as AV Nicking.

Therefore - quit worrying about the medical. Worry about you. Take care of you and the medical will be taken care of. The medical is a physicial. If the physical shows something, you treat it, get your medical and go flying.

Now about getting your hypertension down. Look in the mirror. If you are a bit soft and puggy, quit picking up a dozen donuts to go to work and drop a dozen. As little as 10 pounds of weight loss can drop your pressure a few points.

Exercise - The dreaded "E" word. Self explainatory. Make it a walk with your bride after dinner instead of dessert. Also good for you marriage.

Watch your sodium intake. I did the math 25 years ago in pharmacy school but in layman's terms, don't eat more than 1 teaspsoon of salt a day. Don't forget that sodium is in just about everything. If food never tastes salty to unless you add salt, you are eating too much. A piece of American cheese should taste slightly salty to you. Take the salt shaker off the table and get out of the habit of freely adding salt. Can't stand it - get a salt substitute. Hot sauce works wonders for this since your taste buds are focused on something else.

After deciding to get healthy, drop a few, watch your salt, get some exercise, and if your BP is still elevated, medication is next. If you want a long healthy life and are unwilling to try the above first, then think of it as entering into a lifelong contractual agreement with your physician. Hmm...maybe you should try the above. There is a rather lengthy list of medications used to treat hypertension approved by the FAA. I read someone takes benzapril (which is an ACE inhibitor) which makes a good choice for a pilot due to its side effect profile.

I highly recommend that you go to one of websites that list FAA approved medications such as http://www.leftseat.com/medcat1.htm and print it out to take to your doctor to discuss this with him. Although approved, some medications increase photosensitivity (can you say sunburn) and this is something than can happen in an RV. Diuretics have the potential to make flying uncomfortable unless you have a relief bottle, beta blockers can decrease sexual function (no fun after flying), and the list goes on. Point being, choose wisely and you can have your health and fly too.

All this to say quit worrying about getting past your medical. You are fooling yourself and you need to take care of you which in turn will take care of getting an A+ passing grade. You are also putting me at risk when I'm up there with you. Please take care of both of us.
 
Webb said:
Therefore - quit worrying about the medical. Worry about you. Take care of you and the medical will be taken care of. The medical is a physicial. If the physical shows something, you treat it, get your medical and go flying.
Click to expand...
I agree that you should worry about your health first, but there are plenty of healthy people, some of whom are good pilots, who would not pass the 3rd class medical. There are plenty of things that the FAA will flunk you for just because. Don't think that just because you are managing / treating a condition and are healthy, you will pass the medical.

Some examples:

* Substance abuse (particularly alcoholism). Plenty of pilots lie about this on their medical. Webb's guidance here suggests that you get it treated, which is the right thing. During treatment, should you be grounded? The FAA thinks so.

* Cancer. Even if the disease and/or treatment don't affect you as PIC, you're pretty much grounded until you get a special issuance or are in remission and many months out of chemo. Flying can be an integral part of your recovery. I passed my Sport Pilot BFR and began flying again last year shortly after chemo when I would not have not passed my medical - this really helped improve my spirits a lot. It can also help improve the quality of life for those who have terminal cancer but are not yet affected it by it.

* Migrane headaches - controllable with medication, but cause enough to flunk and good luck with a special issuance. An option is to forego the medication, not control the migranes, and take your chances that you'll get a migrane in flight.... not smart!

* Depression - also controllable with medication, but cause for an automatic fail on the medical. Probably highly unreported on medical applications due to automatic flunking. From what I understand, there are NO exceptions.

You get the idea. I think we'd all be better off if the FAA weren't so draconian on the medical issue, particularly for 3rd class (not-for-hire)medicals. This causes a lot of people to make a choice between flying and health, which is not a good thing. Hence the point Webb is making.

I really like Webb's comments, but if I may, let me modify them and say "Take care of your health and then fly however the FAA lets you." Remember that the Sport Pilot option is out there for those who do not want to fight or - just as importantly - can't spend the money fighting the FAA on the medical issue.

TODR
 
thanks all

Thanks to everyone for replying. You have given me increased motivation to get back in shape.

Just to clear one thing up, I do not have any wish to hide my blood pressure. I know I need to take care of it and if it wasn't for the aviation medical, I may not even have known it was high (it prompted me to go see my regular doctor, who I normally don't see too often). I was mainly concerned if I should hold off on going for my 3rd class until I can hopefully get my BP lower through exercise and loosing weight, or if I could go for it with my BP where it is now (I'm not sure, but I thought if it was too high, I would endlessly be in the FAA database as such).

Anyway, thanks again to all and fly safe.

-wayne
 
How long are you planning to hold off?

Wayne, first of all 135/88 is not considered as having hypertension. Pushing the edge yes, but not there yet.

Do consider it a wake up call before you have to do something about it.
 
No added salt!

Ever since med school I have managed to keep mine in bounds with exercise and a no added salt diet. A few times I have checked my BP after a Mex diner with lots of chips, etc and found things uniformly 10 points higher than when using a little discretion.

If this fails there are numerous GOOD medicines these days that are uniformly effective and tolerable.

Do not ignore the problem--it is one we have some control over.
 
As a data point, mine was 140/74 today when I took (and passed) my physical. About 15 points above the 122/64 my wife had measured over the last several weeks. Guess I must be getting used to this AME and not having quite the white coat problem. Last time it was WAY up the first time he took it, 164/80 IIRC. He retook it later and it was OK. Still, feels good to get that behind me.

Bob Kelly
 
Important topic.

Lots of good advice on this thread.

My bp was slowly, but steadily increasing, and I had white coat to boot.

Turned out that the blood pressure increase was caused by a sleeping disorder, sleep apnea. (Which is, in itself, a grounding "issue", and requires a special issuance med cert.)

I took myself out of flying until things were resolved. The therapy for sleep apnea dramatically reduced my b.p., (and restored my entire health picture).

The FAA was thorough, but fair, and after a complete scoping-out, I'm back in the air, but I need to see my doc yearly for a compliance visit.

My point here is, that if anyone finds his b.p. rising (or is difficult to control, even with meds) consider being evaluated for sleeping disorders. (Especially if you snore or have morning headaches.)

As far as "white coat", routinely taking pressures at home, along with recording pulse, rate will provide much useful info.

And, for the happy ending. My last visit to the AME, the doc said..."120 over 60...perfect!" It had never been "perfect" in the AME's office before.

.
 
Sleep apnea

I had sleep apnea, too, and had the surgery. The recovery was two weeks that were pretty miserable -- wake up, wait till I could take a pain pill, finally get back to sleep, and start the four-hour cycle all over again. But it was well worth it.

My tack with the FAA, once diagnosed, was that I had the surgery, recovered, and had a sleep test afterwards to document the cure. No special issuance medical or anything, but that was maybe 8 years ago.

Turns out that sleep apnea can do all kinds of things that you associate with being really tired all the time -- hard to stay awake, and some folks become ogres from the fatigue. In fact, one of the common results of treatment is that folks "become" really nice -- actually, they'd normally be nice all the time if it weren't for the apnea. And there can be cardiac implications as well.

My favorite observation was that after the surgery, the traffic in Seattle got lighter. Actually, it didn't, but I was more patient. And my reaction times improved substantially, with positive safety implications.

Since apnea is progressive, you don't know that you've got it. I was sure in denial till I took the first sleep test. Bottom line -- if you snore a lot, go get checked out. It may not save your life (in the sense of keeping you from dying early), but it will save your life (in the sense of quality of life).
 
I was inspired by....

I attended the tail building seminar at Ron Alexander's in Griffin Ga. One guy there was a Delta air line pilot. He got up to run every morning which inspired me because you work like a dog in that course to build the tail in a week. He told me he flunked his First Class medical and to get back to flying he ran every day, Rain or shine. I decided it was a good idea and I have been running three days a week for the last four years (coincides with my building). It is hard to do and in the cold dark mornings I think I have lost my rocker. THe 100% humidity days are difficult also. But my BP is in the low normal range and I can still eat Tex Mex and crawfish fetticenelli with impunity.

My 2 cents is medication is ok but exercise relieves stress and keeps the BMR up there. Increased blood to the brain is a good thing if you are having those CRS (cant remember stuff) moments.

Find a good running partner.

RV 7A
One day I will finish
 
The battle with BP & sleep apnea

I too am a member of this club. I have been providing the FAA the annual letter from my doctor about my continued treatment of sleep apnea for 3 years now. However, this last visit to the AME (May 2008) my BP was elevated and we attributed it to "white coat," and I now keep regular track of my the BP at home. I passed the last 3rd class medical, but the elevated BP is concerning. I continue to use my CPAP and it really does make a difference when I get it on before I fall asleep.

I am with you all who are maintaining their medical health to keep flying your RV. I know it is very important to me!! :)
 
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