Medical Mondays: Blood Pressure & Your FAA Medical
In this episode of Medical Mondays, Matthew Bulow breaks down how the Federal Aviation Administration (FAA) evaluates hypertension during the medical certification process. During a pilot exam, an Aviation Medical Examiner (AME) will take a blood pressure reading, and if it does not exceed 155/95 (and the pilot hasn’t used antihypertensive medication in the past 30 days) they can generally expect an in-office issuance if otherwise qualified. Even if a pilot’s blood pressure is elevated at the appointment, the AME has options, including rechecking the reading, obtaining measurements over three separate days or sending the pilot back to their treating physician for further evaluation within a limited timeframe.
For pilots actively treating high blood pressure, certification may still be straightforward under the FAA’s CACI (Conditions AMEs Can Issue) criteria for hypertension. If the pilot is stable on three or fewer acceptable medications, has been symptom-free for at least seven days and is experiencing no adverse side effects, the AME can issue a certificate in the office. However, if a pilot requires four or more medications, has uncontrolled hypertension, uses disallowed medications or presents complicating factors, their case will require FAA review and may result in a special issuance authorization. The bottom line: most well-controlled hypertension cases are manageable—but documentation, medication stability and compliance matter.
Key Insights
- 155/95 Threshold: Blood pressure at or below 155 systolic and 95 diastolic generally qualifies for in-office issuance.
- Recheck Option: AMEs can retake your blood pressure during the exam if the initial reading is elevated.
- Three-Day Rule: AMEs may request readings over three separate days to confirm control before issuing.
- CACI Pathway: Hypertension is a CACI condition, meaning AMEs can issue if specific criteria are met.
- Medication Limit: Use of three or fewer FAA-acceptable medications may qualify for in-office certification.
- Stability Matters: You must be stable on your treatment regimen for at least seven days without side effects.
- Special Issuance Trigger: Four or more medications, uncontrolled readings or adverse effects typically require FAA review.
- Most Cases Workable: Well-managed hypertension rarely ends a pilot’s certification, but poor documentation can delay it.
