Guide for Aviation Medical Examiners

Decision Considerations – Aerospace Medical Dispositions
Item 36. Heart – Hypertension

Hypertension (HTN) – All Classes
Disease/Condition Evaluation Data Disposition
A. No medication

(If treating physician discontinued medications 30 days ago or longer.)

If airman meets standards: ISSUE
Summarize this history in Block 60.
B. Treated with 3 or fewer* acceptable medications. See CACI - Hypertension Worksheet

For additional information, see Hypertension FAQs

Follow the CACI – Hypertension Worksheet. Annotate Block 60.
C. Any of the following:
  • Treated with 4 or more* acceptable medications;

  • HTN is clinically uncontrolled;

  • Unacceptable medications are used;

  • Side effects are present;

  • Medical status of the airman is unclear; or

  • Certification has been specifically reserved to the FAA
Submit the following to the FAA review:

☐ Current status report from treating physician with treatment plan, prognosis and how long the condition has been stable;

☐ Specific mention if there is a secondary cause for HTN or any evidence of a co-morbid condition (ex. diabetes or OSA), or end organ damage (ex. renal insufficiency, kidney disease, eye disease, MI, CVA heart failure, etc); and

☐ List of medications, dates started and stopped, and any side effects.


Submit the information to the FAA for a possible Special Issuance.

Follow up Issuance Will be per the airman's authorization letter

Notes: *Number of medications counts each component. (Example: lisinopril/HCTZ is 2 medications.)

If this airman is new to you or you are not certain of their HTN control, you may request a current status report from the treating physician for your review.

If the airman did not meet standards on exam, See Item 55. Blood Pressure.

Last updated: Thursday, March 23, 2023