12/21/2019
UNQUESTIONABLY, the number-one problem
most pilots have during their routine Federal
Aviation Administration medical examination is
elevated blood pressure (hypertension). This is a concern
not only for getting (and keeping) a medical certificate,
but in preventing the complications of stroke, heart attack,
and kidney failure from years of damage to your heart
and blood vessels.
Hypertension is often called “the silent killer,” because
high blood pressure usually causes no symptoms at all.
This is the reason you should know your pattern of blood
pressure readings, and — if consistently high —get medical
advice. Years of straining to pump blood will really
do a number on your cardiovascular (heart and blood
vessels) system.
The table (below) will give you some reference values.
Remember that the new FAA acceptable level is 155/95. For
example, either 157/80 or 145/98 would be too high.
Systolic pressure is the value (in millimeters of mercury)
in the blood vessels when the heart contracts, and the
diastolic pressure is the reading when the heart relaxes.
One elevated blood pressure reading is certainly not
enough for a diagnosis of hypertension. Blood pressure
varies greatly during the day, changing with time of day,
exercise, stress (such as having an FAA or insurance exam),
fear, anger, anxiety, things you have to eat or drink, and
so on. If a reading is high, additional readings are needed
to see what your pattern or average is. Many people get
“white-coat hypertension”—high readings from the anxiety
of having a health professional (such as your doctor) put
the cuff on your arm and pump it up. I have had it myself.
The FAA realizes the problem and allows the examiner to
take additional readings after you have time to become
more relaxed—even the next day or so.
Although your blood pressure may meet the FAA-acceptable
level of 155/95 or below, levels consistently above
140/90 should be of concern.
For anyone, on or off blood pressure medication,
these four practices will be of great help in correcting
hypertension:
1) Weight reduction if overweight
2) Exercise
3) Low-salt diet
4) Diet low in fats and rich in fruits and vegetables.
(It is assumed that no rational person smokes.)
If you are overweight, a loss of 10 percent body weight
will usually lower your blood pressure 10 percent. So, if
you weigh 220 pounds and lose 22 pounds, an elevated
blood pressure of 150/90 could lower to an acceptable
135/81. You would look and feel better at 198 pounds.
Almost invariably, pilots who have consistently high blood
pressure are overweight.
Exercise must be a part of your plan. Walking briskly
for 30-40 minutes every other day is fine. Physical activity
lowers blood pressure.
All natural foods such as fruits, vegetables, and grains
contain only small amounts of salt (sodium, in the form
of sodium chloride). All processed foods are high in salt.
The food processing companies add salt to make the food
taste better. Our body needs only 200 milligrams (mg)
of salt per day, yet we often consume 6000 mg. Canned
soups (reported to be so healthful) are a good example of
sneaky salt-loading; some contain 800 mg per serving.
Hypertension Categories
Systolic Diastolic
Mild Stage I 140-159 90-99
Moderate Stage II 160-179 100-109
Severe Stage III 180-209 110- 119
Very Severe Stage IV 210 or > 120 or >
Source: National High Blood Pressure Education Program, American Heart Association.
