R

RScott

Well Known Member
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.
 
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.
 
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... :)
 
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.
 
Blood Pressure

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
 
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Take a look here:

http://www.faa.gov/licenses_certifi...cation/specialissuance/hypertension/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.
 
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Jamie said:
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.
Click to expand...

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
 
rv7boy said:
"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.
Click to expand...

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.
 
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Brantel said:
Take a look here:

http://www.faa.gov/licenses_certificates/medical_certification/specialissuance/hypertension/index.cfm
Click to expand...
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.
 
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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.
 
I went on BP medication a couple of years ago. To get the III class medical I showed up at the AME with a doctors copy of my medical records from the previous 6 months with 3 BP readings and a EKG printout. With the medication my BP is normal. He signed me off and sent the data along with the application. I haven't heard anything since. My understanding from him was that as long a nothing changes (like a different medication) and my BP checks out ok future medicals will be no problem.

Doug
 
apatti said:
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.
Click to expand...

You might be interested to know that the salt that you put on food is a lot more efficient at producing a "salty" taste than the salt that you put in your food. You'd be amazed at how unsalty something can taste while still having a boatload of salt in it. Check the labels of various foods and you'll be quite surprised. For example, a serving of potato chips has 180 mg while a serving of spaghetti sauce has 550 mg!
 
If you have high blood pressure, get it treated, (doctor). A total shame to complete a fine RV and drop dead before you get to fly it. :(


If you don't have high blood pressure but suffer from WCS (white coat syndrome), which can get worse by the way if you are worried about high blood pressure! :eek: ; then, put you finger over ONE Carotid Artery. Block the blood flow for a couple seconds. Your brain will sense an increse in blood pressure and for the next few minutes you will get a significantly lower reading. Over doing it or doing BOTH arteries can cause your blood pressure to drop so low you pass out. Then you probably will NEVER get a medical. :eek:

Know your blood pressure. Know if you have high blood pressure. Be proactive. Do not avoid treatment for true high blood pressure.
 
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Randy Walls help?

My BP dropped 20 points (both systolic and diastolic) after 30 min. a day on an eliptical exercise machine for two weeks.


Randy Walls, what is an eliptical exercise machine? I may try this myself.

thanks,
jeff h
 
Everyone I know that has gone on a strict diet cutting down on sugar and starch along with Cardio (High Glycemic Foods) had their Blood Pressure drop big time. One friend, 63 years old, dropped 75 lbs and his blood pressure went down to 110/70 with a resting heart rate of 55 bpm. He had been on high blood pressure meds for 30 yrs. His doctor was amazed. He looks way younger too.

Its takes Discipline.
 
Thanks for all the info. I talked with my friend this morning and he has a great attitude, plans to get some exercise walking the dog this morning, has a doctor appointment soon and it sounds like he intends to do all the right things. I sent him a link to this discussion, so I am sure he will find your comments useful.
 
lsu-rv said:
My BP dropped 20 points (both systolic and diastolic) after 30 min. a day on an eliptical exercise machine for two weeks.


Randy Walls, what is an eliptical exercise machine? I may try this myself.

thanks,
jeff h
Click to expand...

It's hard to describe, kind of a cross between a stair climber and bicycle. Any sporting goods store like Dick's will have one you can try. Really anything that will get your pulse up to the aerobic range will do the trick.
 
From a doctor who treats hypertension (HTN) many times a day:
There are many meds for HTN, and many will begin to work within 2 weeks. However, many of us will prescribe a low dose initially, and ramp up if needed - that may require a couple months to get under control. For example, hydrochlorothiazide (HCTZ - who wants to say the long way??) is one of the top drugs used for HTN, yet a few folks will have adverse reactions and will need to change. So, I would wholeheartedly recommend a longer time interval until re-exam, but for the majority of people, 2 weeks would be enough. Let me also add I have a number of patients that have high BP only when in the office (white coat syndrome), so I always insist they get a machine or check in the store and bring me ample data to help rule in or out.
Regarding lifestyle changes (proper diet, watch salt, lose weight, exercise), most people do NOT comply, and those changes take time to show improvement if they will work at all. We certainly encourage this, and I do have a few patients that have been able to control their BP just fine with these changes, but after 5000 patient visits a year and 11 years in practice, I find them a minority. I certainly understand why some docs don't even mention it much (they should), as they are tired of beating their head on a tree and seeing no result.
To the poster who mentioned the links to stroke, MI, etc., indeed, but it typically takes many years before problems surface, and all those diseases mentioned have many other factors that influence them. I know **** healthy folks who have had all those problems, plus I have known many hypertensives who fall off the radar, are non-compliant, and let their HTN run amok for years and never have anything happen. HTN alone is not directly a problem with flying, but the FAA knows that there are increased risks if left untreated. Interestingly, a strong family history of cardiac disease, smoking, and additive other cardiac risk factors may be more likely to cause these maladies, but the FAA doesn't count them.
Lastly, to the poster who recommended the carotid artery massage trick, I say absolutely not (as do my cardiology and vascular surgery colleagues). While most people would be OK doing that, if one has an undiagnosed non-symptomatic blockage in that artery and they did that, they could invoke a passing out spell or worse (you do NOT need to block both arteries).
Best wishes to your friend,
Carl
Family Practice
 
Advice for those trying to lose weight

At 45 yrs, 6', 172 lbs I am in no way obese, but as an avid cyclist, I had been wishing for some time now to get my weight from 178-180 down to 170-ish. The spare tire has been slowly growing over the last several years and looked to be about 10 lbs. A few weeks ago I did some reading and decided that I needed to cut out the sugar in my diet. It had always been my custom to start the day with a big bowl of cereal for the carbs and the fiber. What I had never thought about was how much sugar is in that stuff. A lot of other stuff I was eating also has gobs of refined sugar and simple carbs that apparently send your blood sugar up, then down, leading to extreme crash/hunger which in turn leads to overeating, etc. So for about a month I've been starting the day with some protein, either in the form of eggs or turkey sausage and whole grain muffin or toast. I make it a point to eat some protein in every meal, and avoid anything with more than just a couple of grams of sugar. I can report that it is definitely making a difference and has not been particularly difficult. My pants are gradually stating to fit looser around the waist and my energy level remains much more steady through the day. Take a look at the labels and you'll see that the high fructose corn syrup is everywhere. Finally, if you like the soda pop you gotta give it up. Here's what you do: Get whatever fruit juice you like and mix it with carbonated water in about a 25% juice/75% bubble-water. Very refreshing, low sugar, a few viatmins too. Sorry to sound like your mother :D . YMMV.
 
Sugar, continued....

Steve, You are right on track!! I've been resisting adding my 2 cents worth but finally am caving in. Approximately 5 years ago my BP had gotten to 140/110 and I was sure to lose my medical. A good friend convinced me to do the low sugar and carb thing and see if helped. Long story short, 6 weeks later BP was 107/72 consistently. Still there today. I lost some of the weight I should but am still a big guy at 225 and 6' but blood pressure is not a problem. If I stayed strict with the diet I would have continued to lose weight, I just haven't done it.
To the fellow on the elyptical trainer, I rode a lifestyle fitness trainer every morning for about 14 months. I increased time to 30 minutes the first week and increased levels of resistence from 6 to 17 of 24. It finally got me down to the point I was wore out!!!! About 2 months ago I switched to 4 times a week and feel tremendously better!! Don't know all the reasons behind it but it is fact.
Just couldn't resist chiming in, they say the greatest test of will power is to have the same 'ailment' that someone is telling you about and not mention it!!!
Take Care,
Greg
 
CAP helps too...

Oh, and one little extra incentive to lose weight. If you join CAP as I have there are height and weight limits to wearing the AF style uniforms. At 219 pounds I can start wearing the green flightsuit instead of the funny looking blue one.

--JCB
 
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