Hypertension (High Blood Pressure) – Technical aspects

Author: Dr Philip Ranger

During every pilot’s medical one test that will always be performed is a measurement of blood pressure. This may be taken standing or, more unusually lying or sitting. The blood pressure measurement is recorded as x/y, where ‘x’ is the systolic pressure and ‘y’ the diastolic. To pass a pilot’s medical this figure must be within normal or sometimes” acceptable” limits. I am often asked “what is a normal blood pressure”. There is, of course no one figure. The often quoted reading is 120/80 but this is merely one normal reading and lower/higher figures may also be normal. Blood pressure is affected by age, overweight and poor physical habits even when there is no true blood pressure problem. It is well known that anxiety (“white coat syndrome”) can cause a blood pressure to be elevated and the worry of a pilot’s medical may have this effect.

There is a difference between “acceptable” figures at the initial and revalidation pilots medicals. At the initial a figure of 140/90 requires a further reading followed by a third. If the figure is still “abnormal” the process of investigating the condition must be started. (see third article). For other medicals, the upper limit of ‘high’ levels is 165/95 and the lower 130/90. Below this figure there is no problem although a large change from the previous pilots medical would be noted.

In the ‘abnormal range’ a number of factors may be considered. If the pilot appears very nervous, the C.A.A. have suggested that it is reasonable to consider reducing the systolic pressure by 20 units and the diastolic by 10 units. In slightly elevated cases, it will help the pilot at his/her medical if they have brought a series of ‘home’ readings as many pilots own their own blood pressure machines. These readings should, ideally, be taken at different times of day and different situations. I always encourage pilots, where possible, to bring in their own readings.

My comment about “acceptably” (high) readings would, therefore, apply to pilots who have a somewhat elevated figure but bring in a series of reasonable ‘own’ readings.

In terms of health; cardiovascular risk (of heart attack and stroke) continues to fall with levels under 120/80 until very low levels are reached.


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