High blood pressure
What the FAA's documents say about high blood pressure, in plain words, with the FAA's own words one press away.
FAA term: Hypertension
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ANo medication. If the treating physician discontinued medications, that was 30 days ago or longer. | Examiner issues | Examiner can issue |
| Row BTreated with three or fewer acceptable medications. | Worksheet | CACI |
| Row CTreated with 4 or more acceptable medications, HTN that is clinically uncontrolled, unacceptable medications used, side effects present, the pilot's medical status unclear, or certification specifically reserved to the FAA. | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for High blood pressure
- Row A · Examiner can issue
No medication. If the treating physician discontinued medications, that was 30 days ago or longer. The Guide says the examiner issues if the pilot meets standards, and summarizes this history in Block 60.
No medication (If treating physician discontinued medications 30 days ago or longer.) If airman meets standards: ISSUE Summarize this history in Block 60.
- Row B · CACI
Treated with three or fewer acceptable medications. The Guide sends the examiner to the CACI worksheet for high blood pressure, and has the examiner note it in Block 60. The worksheet says the examiner can issue if the pilot meets all the acceptable certification criteria it lists.
Treated with 3 or fewer* acceptable medications. Follow the CACI – Hypertension Worksheet. Annotate Block 60.
If the applicant meets ALL the acceptable certification criteria listed below, the AME can issue.
- Row C · Special Issuance
Treated with 4 or more acceptable medications, HTN that is clinically uncontrolled, unacceptable medications used, side effects present, the pilot's medical status unclear, or certification specifically reserved to the FAA. The examiner defers and sends the listed information to the FAA for a possible Special Issuance.
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: … DEFER Submit the information to the FAA for a possible Special Issuance.
- A note on the table, 1
The Guide's table counts each component in the number of medications; its example is lisinopril/HCTZ, which is 2 medications.
Number of medications counts each component. (Example: lisinopril/HCTZ is 2 medications.)
- A note on the table, 2
The Guide's questions and answers take the case where the treating physician stopped the medications less than 30 days ago, and send the examiner to row B of the table and the worksheet.
What if the treating physician stopped the medications less than 30 days ago? See Section B of the Hypertensive Disposition Table and follow the CACI - Hypertension Worksheet.
- A note on the table, 3
The Guide's table notes that if the pilot is new to the examiner, or the examiner is not certain of their HTN control, the examiner may request a current status report from the treating physician for their review.
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.
- A note on the table, 4
The Guide's questions and answers take the case of a pilot on an HTN medication that is not allowed by the FAA: the treating physician can evaluate if the pilot can safely be changed to an acceptable HTN medication. If the medication(s) can be changed and the pilot meets the required criteria, they should submit the items as detailed in Section C of the Hypertensive Disposition Table for FAA review, and the treating physician note should describe the clinical rationale as to why the unacceptable medication was previously chosen and why it is ok for the pilot to be on a different medication now. If the pilot cannot safely be changed to an acceptable HTN medication, the examiner is to defer the exam and send in the documents listed in Section C of the Hypertensive Disposition Table for FAA review.
What if the airman is on a HTN medication that is not allowed by the FAA? … The treating physician can evaluate if the airman can safely be changed to an acceptable HTN medication. … If the medication(s) can be changed and the airman meets the required criteria, they should submit the items as detailed in Section C of the Hypertensive Disposition Table for FAA review. … The treating physician note should describe the clinical rationale as to why the unacceptable medication was previously chosen and why it is ok for the airmen to be on a different medication now. … If the airman cannot safely be changed to an acceptable HTN medication, defer the exam and send in the documents listed in Section C of the Hypertensive Disposition Table for FAA review.
- A note on the table, 5
The Guide's questions and answers take the case of a pilot whose medication(s) were adjusted and who now meets the standards, but where it took longer than 14 days and the exam was deferred. If the pilot is now well controlled and is on 3 or fewer medications, the examiner is to direct them to the CACI - Hypertension Worksheet; if the pilot is on 4 or more medications (combination medications count as the sum of their parts), to the Hypertension Disposition Table. Either way, they should obtain the required information from their treating physician and submit it to the FAA.
The airman had medication(s) adjusted and now meets the standards, but it took longer than 14 days and the exam was deferred. What can the airman do now? … If the airman is now well controlled and is on 3 or fewer medications, direct them to the CACI - Hypertension Worksheet. They should obtain the required information from their treating physician and submit it to the FAA. … If the airman is on 4 or more medications (combination medications count as the sum of their parts), direct them to the Hypertension Disposition Table. They should obtain the required information from their treating physician and submit it to the FAA.
The FAA pathways for high blood pressure
Which exam
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: A progress note from your treating doctor or specialist
The note the examiner must review, and when that review is not required.Within 90 days before the examA current, detailed progress note from a clinic visit with your treating physician or specialist, no more than 90 days before the exam. Your AME reviews it.
When it is not needed
Your AME does not need it if they can otherwise determine at least 7 days of stable blood pressure control on your current medication, without symptoms or side effects, and with no treatment changes recommended.
Show the FAA's words: A progress note from your treating doctor or specialist
the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam.
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
the AME is not required to review a Clinical Progress Note from the treating physician IF the AME can otherwise determine that the applicant has had stable clinical blood pressure control on the current antihypertensive medication for at least 7 days, without symptoms from the hypertension or adverse medication side-effects, and no treatment changes are recommended.
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Step 2: The worksheet's criteria
Stability, symptoms, blood pressure in office, your medications and side effects.Up to 3 acceptable blood pressure medications, in combination.
The kinds allowed
- Alpha blockers
- Beta-blockers
- Calcium channel blockers
- Diuretics
- ACE inhibitors
- ARBs
- Direct renin inhibitors
- Direct vasodilators
The FAA's medication sheet also lists endothelin receptor antagonists as acceptable, when certification criteria are met.
Not acceptable
- Not: Centrally acting antihypertensives, such as clonidine
- Not: Guanabenz, guanfacine, methyldopa or nitrates, alone or in any combination
The worksheet's other criteria
- Stable on the current treatment for at least 7 days, with no changes recommended
- No symptoms
- Blood pressure in the office of 155 systolic and 95 diastolic or lower
- No side effects from the medications
Show the FAA's words: The worksheet's criteria
Acceptable medication(s)
See Pharmaceuticals - Antihypertensive
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. NOT acceptable: Centrally acting antihypertensive (ex: clonidine)
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
ACCEPTABLE HTN Medications (when certification criteria are met)
Alpha adrenergic blockers
Calcium channel blockers
Angiotensin converting enzyme (ACE) inhibitors
Direct renin inhibitors
Angiotensin II receptor antagonists (ARBs)
Direct vasodilators
Beta-adrenergic blockers
Diuretics
Endothelin Receptor Antagonists
FAA source: Antihypertensive (HTN, blood pressure medication). FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
UNACCEPTABLE HTN Medications (as a single agent or in any combination product)
DO NOT ISSUE
Clonidine (ex. Catapres/Clorpres)
guanabenz
guanfacine/Tenex
methyldopa
Nitrates (ex. nitroglycerin/isosorbide dinitrate/isosorbide mononitrate)
FAA source: Antihypertensive (HTN, blood pressure medication). FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
Treating physician or the AME finds the condition stable on current regimen for at least 7 days and no changes recommended.
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA
Symptoms [ ] None
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Blood pressure in office [ ] Less than or equal to 155 systolic and 95 diastolic (Although 155/95 is acceptable for certification, the airman should be referred to their primary provider for further management, if the blood pressure is above clinical practice standards)
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Side effects from medications [ ] No
FAA source: CACI – Hypertension Worksheet. FAA date 13 April 2022; checked by Crosscheck 14 October 2026.
Step 3: Starting a new blood pressure medication
The FAA's antihypertensive sheet's no fly/ground trial.- You: A seven-day (7) no fly/ground trial when starting a new HTN medication, to verify no side effects
Show the FAA's words: Starting a new blood pressure medication
Seven-day (7) no fly/ground trial is required when starting a new hypertension (HTN) medication to verify no side effects.
FAA source: Antihypertensive (HTN, blood pressure medication). FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
The Guide says the examiner issues if the pilot meets standards, and summarizes this history in Block 60.
Row BWorksheetCACI
The Guide sends the examiner to the CACI worksheet for high blood pressure, and has the examiner note it in Block 60. The worksheet says the examiner can issue if the pilot meets all the acceptable certification criteria it lists.
Row CDefers to the FAASpecial Issuance
The examiner defers and sends the listed information to the FAA for a possible Special Issuance.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
No medication. If the treating physician discontinued medications, that was 30 days ago or longer. The Guide says the examiner issues if the pilot meets standards, and summarizes this history in Block 60.
No medication (If treating physician discontinued medications 30 days ago or longer.) If airman meets standards: ISSUE Summarize this history in Block 60.
- Row B · CACI
Treated with three or fewer acceptable medications. The Guide sends the examiner to the CACI worksheet for high blood pressure, and has the examiner note it in Block 60. The worksheet says the examiner can issue if the pilot meets all the acceptable certification criteria it lists.
Treated with 3 or fewer* acceptable medications. Follow the CACI – Hypertension Worksheet. Annotate Block 60.
If the applicant meets ALL the acceptable certification criteria listed below, the AME can issue.
- Row C · Special Issuance
Treated with 4 or more acceptable medications, HTN that is clinically uncontrolled, unacceptable medications used, side effects present, the pilot's medical status unclear, or certification specifically reserved to the FAA. The examiner defers and sends the listed information to the FAA for a possible Special Issuance.
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: … DEFER Submit the information to the FAA for a possible Special Issuance.
The CACI worksheet's criteria
Progress note
Your AME does not need it if they can otherwise determine at least 7 days of stable blood pressure control on your current medication, without symptoms or side effects, and with no treatment changes recommended.
Your blood pressure medications
The kinds allowed
- Alpha blockers
- Beta-blockers
- Calcium channel blockers
- Diuretics
- ACE inhibitors
- ARBs
- Direct renin inhibitors
- Direct vasodilators
The FAA's medication sheet also lists endothelin receptor antagonists as acceptable, when certification criteria are met.
Not acceptable
- Not: Centrally acting antihypertensives, such as clonidine
- Not: Guanabenz, guanfacine, methyldopa or nitrates, alone or in any combination
The worksheet's other criteria
- Stable on the current treatment for at least 7 days, with no changes recommended
- No symptoms
- Blood pressure in the office of 155 systolic and 95 diastolic or lower
- No side effects from the medications
Show the FAA's words: the CACI worksheet's criteria for High blood pressure
- The worksheet's exception to the progress note
The worksheet says the examiner is not required to review a clinical progress note from the treating physician if the examiner can otherwise determine that the pilot has had stable clinical blood pressure control on the current antihypertensive medication for at least 7 days, without symptoms from the hypertension or adverse medication side effects, and no treatment changes are recommended.
the AME is not required to review a Clinical Progress Note from the treating physician IF the AME can otherwise determine that the applicant has had stable clinical blood pressure control on the current antihypertensive medication for at least 7 days, without symptoms from the hypertension or adverse medication side-effects, and no treatment changes are recommended.
- Stable on the current regimen, with no changes recommended
FAA criterion: the treating doctor or the examiner finds the condition stable on the current regimen for at least 7 days, with no changes recommended.
Treating physician or the AME finds the condition stable on current regimen for at least 7 days and no changes recommended.
- No symptoms
FAA criterion: no symptoms.
AME MUST REVIEW ACCEPTABLE CERTIFICATION CRITERIA … Symptoms [ ] None
- Blood pressure in office
The worksheet's criterion: blood pressure in office less than or equal to 155 systolic and 95 diastolic. Although 155/95 is acceptable for certification, the worksheet says the pilot should be referred to their primary provider for further management if the blood pressure is above clinical practice standards.
Blood pressure in office [ ] Less than or equal to 155 systolic and 95 diastolic (Although 155/95 is acceptable for certification, the airman should be referred to their primary provider for further management, if the blood pressure is above clinical practice standards)
- Medications from the kinds the worksheet lists
FAA criterion: combinations of up to 3 of the following are allowed -- alpha blockers, beta-blockers, calcium channel blockers, diuretics, ACE inhibitors, ARBs, direct renin inhibitors, and/or direct vasodilators. The worksheet names centrally acting antihypertensives, such as clonidine, as not acceptable. Its acceptable-medication line refers to the FAA's antihypertensive sheet, which also lists endothelin receptor antagonists as acceptable when certification criteria are met; the worksheet's combinations line does not name them. The antihypertensive sheet lists clonidine, guanabenz, guanfacine, methyldopa and nitrates as unacceptable, as a single agent or in any combination product, under Do Not Issue.
Acceptable medication(s) … See Pharmaceuticals - Antihypertensive … 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. NOT acceptable: Centrally acting antihypertensive (ex: clonidine)
ACCEPTABLE HTN Medications (when certification criteria are met) … Alpha adrenergic blockers … Calcium channel blockers … Angiotensin converting enzyme (ACE) inhibitors … Direct renin inhibitors … Angiotensin II receptor antagonists (ARBs) … Direct vasodilators … Beta-adrenergic blockers … Diuretics … Endothelin Receptor Antagonists
UNACCEPTABLE HTN Medications (as a single agent or in any combination product) … DO NOT ISSUE … Clonidine (ex. Catapres/Clorpres) … guanabenz … guanfacine/Tenex … methyldopa … Nitrates (ex. nitroglycerin/isosorbide dinitrate/isosorbide mononitrate)
- No side effects from the medications
FAA criterion: no side effects from the medications.
Side effects from medications [ ] No
If the examiner defersSpecial Issuance
The Guide's table (Item 36) lists when the examiner defers. That is treatment with 4 or more acceptable medications, HTN that is clinically uncontrolled, unacceptable medications used, side effects present, the pilot's medical status unclear, or certification specifically reserved to the FAA. The Guide's Item 55 page says the examiner must defer issuance of a medical certificate to any applicant whose hypertension has not been evaluated, who uses unacceptable medications, whose medical status is unclear, whose hypertension is uncontrolled, who manifests significant adverse effects of medication, or whose certification has previously been specifically reserved to the FAA.
What the FAA lists to send
- Item 1. A current status report from the treating physician, with the treatment plan, the prognosis, and how long the condition has been stable.
- Item 2. Specific mention if there is a secondary cause for HTN or any evidence of a co-morbid condition (for example diabetes or OSA), or end organ damage (for example renal insufficiency, kidney disease, eye disease, MI, CVA heart failure, etc).
- Item 3. A list of medications, with the dates each was started and stopped, and any side effects.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The Guide's table (Item 36) lists when the examiner defers. That is treatment with 4 or more acceptable medications, HTN that is clinically uncontrolled, unacceptable medications used, side effects present, the pilot's medical status unclear, or certification specifically reserved to the FAA. The Guide's Item 55 page says the examiner must defer issuance of a medical certificate to any applicant whose hypertension has not been evaluated, who uses unacceptable medications, whose medical status is unclear, whose hypertension is uncontrolled, who manifests significant adverse effects of medication, or whose certification has previously been specifically reserved to the FAA.
Item 36. Heart – Hypertension … 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 … DEFER Submit the information to the FAA for a possible Special Issuance.
Item 55. Blood Pressure … The Examiner must defer issuance of a medical certificate to any applicant whose hypertension has not been evaluated, who uses unacceptable medications, whose medical status is unclear, whose hypertension is uncontrolled, who manifests significant adverse effects of medication, or whose certification has previously been specifically reserved to the FAA.
What the FAA lists to send
- Item 1
A current status report from the treating physician, with the treatment plan, the prognosis, and how long the condition has been stable.
Current status report from treating physician with treatment plan, prognosis and how long the condition has been stable;
- Item 2
Specific mention if there is a secondary cause for HTN or any evidence of a co-morbid condition (for example diabetes or OSA), or end organ damage (for example renal insufficiency, kidney disease, eye disease, MI, CVA heart failure, etc).
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
- Item 3
A list of medications, with the dates each was started and stopped, and any side effects.
List of medications, dates started and stopped, and any side effects.
After the FAA decides
After a Special Issuance, later certificates follow the pilot's own Authorization letter from the FAA.
Show the FAA's words: after the FAA decides
Follow up Issuance Will be per the airman's authorization letter
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workAt later examsAASI
- First and second class
- Every year
- Third class
- At each required exam
The worksheet says first- and second-class applicants must provide this information every year, and third-class applicants must provide it with each required exam.
Show the FAA's words: how often the FAA asks again
Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam.
Under an Authorization, the AASI page lists what the pilot brings for the examiner to reissue: the Authorization itself, and a current status report from the treating physician. The report details whether the condition is stable and for how long, any secondary cause, any co-morbid condition, any history of end organ damage, and the name and dosage of the medications with the presence or absence of side effects.
Show the FAA's words: at later exams
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: An Authorization granted by the FAA; A current status report from the treating physician detailing: If the is condition stable and, if so, for how long; Any secondary cause for the HTN; Any co-morbid condition (such as diabetes, obstructive sleep apnea); and Any history of end organ damage (such as heart failure, myocardial infarction, cerebrovascular accident, kidney disease, eye disease); and The name and dosage of medication(s) and presence or absence of any side effects.
What AASI is
AASI stands for AME Assisted Special Issuance. The Guide describes it as a process that lets the examiner reissue a certificate under the provisions of an Authorization for Special Issuance, to an applicant who has a medical condition that is disqualifying under 14 CFR part 67.
How the FAA pathways workThe Authorization granted by the FAA
The AASI page's first item for a reissue is the Authorization the FAA granted.
Show the FAA's words: The Authorization granted by the FAA
An Authorization granted by the FAA;
A current status report from the treating physician
For a reissue the AASI page asks for a current status report from the treating physician.
Show the FAA's words: A current status report from the treating physician
A current status report from the treating physician detailing:
What the status report details
The report details whether the condition is stable and for how long, any secondary cause, any co-morbid condition, any history of end organ damage, and the name and dosage of the medications with the presence or absence of side effects.
Show the FAA's words: What the status report details
If the is condition stable and, if so, for how long; … Any secondary cause for the HTN; … Any co-morbid condition (such as diabetes, obstructive sleep apnea); and … Any history of end organ damage (such as heart failure, myocardial infarction, cerebrovascular accident, kidney disease, eye disease); and … The name and dosage of medication(s) and presence or absence of any side effects.
What the Authorization letter comes with
The AASI page says the Authorization letter comes with attachments that specify the information the treating doctors must provide for the reissue determination.
Show the FAA's words: What the Authorization letter comes with
The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.
When the examiner defers a reissue
The AASI page says the examiner must defer to the AMCD or Region if the condition is not stable or has become uncontrolled (per the treating physician note), the pilot is taking a medication that is not acceptable, the pilot has aeromedically significant side effects from the medication, there is a new co-morbid condition, complication or end organ damage, or the end organ damage condition(s) do not meet FAA requirements.
Show the FAA's words: When the examiner defers a reissue
The Examiner must defer to the AMCD or Region if: The condition is not stable or has become uncontrolled (per the treating physician note); The airman is taking a medication that is not acceptable … The airman has aeromedically significant side effects from the medication; There is a new co-morbid condition, complication, or end organ damage; or The end organ damage condition(s) do not meet FAA requirements.
Good to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
A high reading need not mean deferral
The Guide's questions and answers say a reading above 155/95 during the exam does not necessarily mean deferral. The examiner may recheck it, or have the pilot return on 3 separate days over a 7-day period, noting the readings in Block 60 if the pilot meets FAA limits, or send the pilot back to the treating physician.
Show the FAA's words: good to know, 2
If during the exam the airman’s blood pressure is higher than 155/95, do I have to defer? Not necessarily. If the airman’s blood pressure is elevated in clinic, you have any the following options: … Recheck the blood pressure. If the airman meets FAA specified limits on the second attempt, note this in Block 60 along with both readings. Have the airman return to clinic 3 separate days over a 7-day period. If the airman meets FAA specified limits during these re-checks, note this and the readings in Block 60. Also note if there was a reason for the blood pressure elevation. Send the airman back to his/her treating physician for re-evaluation.
An applicant whose pressure does not exceed 155 mm mercury systolic and 95 mm mercury diastolic maximum pressure, who has not used antihypertensive medication for 30 days, and who is otherwise qualified should be issued a medical certificate by the Examiner.
An exam stays open no more than 14 days
The examiner cannot hold an exam open longer than 14 days while the pilot gathers information.
Show the FAA's words: good to know, 3
Can I hold an exam longer than 14 days to allow the airman time provide the necessary information? No.
A medication change brings a 7-day no-fly
When the pilot is sent back to the treating physician and medication adjustment is needed, a 7-day no-fly period applies to verify no problems with the medication. If this fits within the 14 day exam transmission period, the examiner could then follow the Hypertension Disposition Table.
Show the FAA's words: good to know, 4
Send the airman back to his/her treating physician for re-evaluation. If medication adjustment is needed, a 7-day no-fly period applies to verify no problems with the medication. If this can be done within the 14 day exam transmission period, you could then follow the Hypertension Disposition Table.
A pilot who stopped medication to fly
For a pilot who stopped the medication on their own so they could fly, the Guide's questions and answers say to educate the pilot (and the treating physician, if needed) that most HTN medications are acceptable and almost no one is denied for HTN.
Show the FAA's words: good to know, 5
What if the airman stopped the medication on his/her own so they could fly? Educate your airman (and their treating physician, if needed) that most HTN medications are acceptable and almost no one is denied for HTN.
Each condition needs its own information
The Guide's questions and answers say a pilot with multiple conditions, such as HTN, obstructive sleep apnea and/or a prior heart attack, must provide the required information for each one.
Show the FAA's words: good to know, 6
What if the airman has multiple conditions, e.g. HTN, Obstructive Sleep Apnea, and/or prior heart attack? The airman must provide the required information for each condition.
The first AASI is deferred to the FAA
When this is a first-time application for this AASI and the applicant has all the requisite medical information for a determination, the examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
Show the FAA's words: good to know, 7
If this is a first-time application for an AASI for the above disease/condition, and the applicant has all the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or RFS for the initial determination.
Block 60 carries one of three statements
The worksheet says the examiner must note one of three in Block 60: CACI qualified (documents do not need to be submitted to the FAA); has current or previous SI/AASI but now CACI qualified; or NOT CACI qualified, which says the examiner has deferred and to submit supporting documents.
Show the FAA's words: good to know, 8
AME MUST NOTE in Block 60 one of the following: … CACI qualified hypertension. (Documents do not need to be submitted to the FAA.) … Has current OR previous SI/AASI but now CACI qualified hypertension. … NOT CACI qualified hypertension. I have deferred. (Submit supporting documents.)
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Open to print: CACI – Hypertension Worksheet, a PDF at the FAA, in a new tab
- Open to print: Guide for Aviation Medical Examiners – Item 36. Heart – Hypertension, a page at the FAA, in a new tab
- Guide for Aviation Medical Examiners – AASI for HypertensionOpen to print: Guide for Aviation Medical Examiners – AASI for Hypertension, a page at the FAA, in a new tab
The sheet the examiner follows to reissue under an FAA Authorization.
AASI
- Open at the FAA: Hypertension (HTN) – Frequently Asked Questions (FAQs), a PDF at the FAA, in a new tab
- Open at the FAA: Antihypertensive (HTN, blood pressure medication), a PDF at the FAA, in a new tab
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
- Open at the FAA: Exam Techniques – Item 55, Blood Pressure, a page at the FAA, in a new tab
Related conditions
Each has its own page, with what the FAA's documents say about it.
Medication guidance
Medications Crosscheck lists as taken for high blood pressure, each with its own page on what published FAA guidance says about it.
- Angiotensin converting enzyme (ACE) inhibitor
- Alpha adrenergic blocker
ARBs (angiotensin II receptor blockers)
Angiotensin II receptor antagonist (ARB)- Beta-adrenergic blocker
- Calcium channel blocker
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.