Hypertension & Blood Pressure Meds

Hypertension (high blood pressure) is the most common medical condition among active pilots and, fortunately, one of the most straightforward to certify. The FAA allows a wide range of antihypertensive medications and, in most cases, your AME can issue your medical certificate at the time of the exam as long as your blood pressure is within acceptable limits and you are not experiencing significant medication side effects. No special issuance is required for well-controlled hypertension.

The FAA generally accepts blood pressure readings up to 155/95 mmHg at the time of the AME exam, though optimal control below 140/90 is recommended. If your reading exceeds the threshold on exam day, most AMEs will allow you to rest and retake the measurement. Persistent elevation above the limit will require documentation from your treating physician confirming adequate control outside the exam setting — home blood pressure logs or 24-hour ambulatory monitoring can satisfy this requirement.

While most antihypertensives are acceptable, certain classes of blood pressure medications are specifically prohibited. Centrally-acting agents such as guanfacine, clonidine, and methyldopa are disqualifying because of their sedative and cognitive side effects. Most beta-blockers are acceptable, though some AMEs may want additional documentation if you are on a high dose. ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics are all routinely approved. If you are on multiple medications, each must individually be an acceptable agent. Pilots switching medications should be aware of the FAA's general recommendation to allow at least two weeks on a new medication before flying to ensure there are no adverse side effects.