Guide for Aviation Medical Examiners
Decision Considerations
Disease Protocols
Hypertension - Initial
The Examiner may issue first-, second-, or third-class medical certificates to otherwise qualified airmen whose hypertension is adequately controlled with acceptable medications without significant adverse effects. In such cases, the Examiner shall:
- Conduct an evaluation or, at the applicant's option, review the report of a current (within preceding 6 months) cardiovascular evaluation by the applicant's attending physician. This evaluation must include pertinent personal and family medical history, including an assessment of the risk factors for coronary heart disease, a clinical examination including at least three blood pressure readings separated by at least 24-hours each, a resting ECG, and a report of fasting plasma glucose, cholesterol (LDL/HDL), triglycerides, potassium, and creatinine levels. A maximal electrocardiographic exercise stress test will be accomplished if it is indicated by history or clinical findings. Specific mention must be made of the medications used, their dosage, and the presence, absence, or history of adverse effects. The initiation of medication or change in dosage is not disqualifying. However, the applicant must not exercise the privileges of the medical certificate for at least 2 weeks. Upon reevaluation, if the blood pressure is controlled without side effects the applicant may resume flying duties. In rare cases where the initial hypertension was severe, additional time may be necessary for normalization of renal and cerebral vascular circulation.
- Summarize the results of this evaluation in Item 60 of the transmitted application and forward the appropriate documents to the AMCD.
- Report the results of any additional tests or evaluations that have been accomplished.
- If appropriate, state in Item 60 on the FAA Form 8500-8 that the applicant's blood pressure is adequately controlled with acceptable medication, there are no known significant adverse effects, and no other cardiovascular, cerebrovascular, or arteriosclerotic disease is evident.
- Defer certification if the person declines any of the recommended evaluations.
