Getting your FAA medical certificate with high blood pressure does not have to be difficult. High blood pressure or “hypertension” is a condition that is covered by the FAA’s “CACI” program which stands for “Conditions AMEs Can Issue.” As a result, with a bit of preparation, there is a good chance that your Aviation Medical Examiner (“AME”) will be able to issue your FAA medical certificate without the need to defer your application to the FAA for further consideration, if you are found to otherwise be qualified. Of course, avoiding a deferral to the FAA’s Office of Aerospace Medicine can save you from waiting for months while the FAA reviews your medical history to determine whether you are eligible for medical certification. Avoiding a deferral and having all your ducks in a row early is the key to getting your FAA medical certificate with high blood pressure.
It is wise that if you are applying for a FAA medical certificate with high blood pressure that you first consult with your treating physician about how to best manage your hypertension. Ultimately, the FAA wants to ensure that you are healthy and that your medical status is stable. Having a good treatment plan in place with your physician will be the first step to demonstrating stability with the FAA.
To that end, the FAA’s CACI requirements for hypertension begin with a suggestion that you provide your Aviation Medical Examiner with a detailed clinical progress note from your treating physician. Typically, your primary care physician, cardiologist, or whichever prescribes blood pressure medication to you would be an appropriate individual to author this note. This detailed clinical progress note should be no more than 90 days old at the time at which you are examined by your Aviation Medical Examiner.
In a relatively rare exception to most CACI condition protocol, however, the FAA will actually allow an Aviation Medical Examiner to forgo the need for a detailed clinical progress note if your AME can otherwise determine that your blood pressure has been stable for at least the most recent 7 days while taking blood pressure medication and that you are not experiencing any symptoms from high blood pressure and that you are not experiencing adverse medication side-effects. The AME must also believe that a change in treatment is not appropriate.
The criteria for an airman to qualify for the FAA’s CACI program for high blood pressure is that:
- Your treating physician or your AME finds the condition stable on the current regimen for at least 7 days and no changes recommended.
- You are experiencing no symptoms or side effects from medication.
- Your blood pressure at the time of examination with your AME is less than or equal to 155 systolic and 95 diastolic.
- You are using an acceptable combination of medications.
If your blood pressure exceeds these limitations, the FAA will require that your AME defer your application to the FAA’s Office of Aerospace Medicine for further consideration. Upon deferral, it is likely that the FAA will require that you provide additional evidence from your treating physician or a cardiologist in an effort to understand the etiology of your high blood pressure as well as to develop a better treatment plan for stability. In some cases, the FAA may require that an airman be followed or monitored by the FAA on an AME Assisted Special Issuance Authorization (“AASI”).
We recommend that you consider the following when applying for a FAA medical certificate with high blood pressure, especially when applying for the first time with this issue:
- Even though your AME is capable of determining whether you are qualified for the CACI program without a letter from your treating physician, there is no reason to take this risk. Arm yourself with a letter from your treating physician which clearly identifies your eligibility under the FAA’s CACI protocol before you even make an appointment with your AME for examination. In doing so, you are giving the AME additional leverage to agree that you are CACI qualified.
- If you provide your AME with a detailed clinical progress note from your treating physician, keep in mind that the AME (and FAA) will scrutinize the entirety of that record. If there is any additional information on this report which indicates an otherwise aeromedically significant concern (even if related to a different condition, symptom, or social habit), the FAA or your AME may require more information regarding that concern.
- Consider the FAA’s acceptable combination of anti-hypertensive medications. Specifically, the FAA will authorize combinations of up to 3 of the following: Alpha blockers, Beta-blockers, calcium channel blockers, diuretics, ACE inhibitors, ARBs, direct renin inhibitors, and/or direct vasodilators are allowed. The FAA will not accept centrally acting anti-hypertensive medications, such as Clonidine, under the CACI program.
- If you are applying for a first- or second- class medical certificate, you must provide the detailed clinical progress note annually; if you are applying for a third-class medical certificate, you must provide the information with each required exam.
- As with all conditions, maintaining your health should be paramount. If you are not able to maintain an acceptable blood pressure while using a combination of approved medications, you should consider speaking with your physician about remedies purely for the sake of your health and well-being.
- Start your FAA medical certification process as soon as possible. Having your documentation and supporting evidence prepared and submitted before your AME examination can potentially save you months of processing time in some cases where a deferral is necessary.
If you are facing getting your FAA medical certificate with high blood pressure, consider a consultation with a FAA medical defense attorney at The Ison Law Firm before applying for a FAA medical certificate. We are happy to evaluate your case and discuss with you a plan for presenting your case to your AME or the FAA. Aviation law is all we do. Nothing else.
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