blood pressure

[Fox6]

Hello, I was wanting to hear from a few people who may be using blood pressure medicine and have FAA medicals. I know what the FAR's say regarding the process of obtaining one, I was just wondering in real life how the process was. Mine is creeping up and the thought of having to do this is scary to say the least. Hopefully it is no big deal.

Thanks

[Flyin'Dutch']

Fox6,

No big issue for the FAA.

Make sure it is well controlled and within the range (IIRC 155/90).

Your AME can (and most will) advice on what medication is OK (most is)

FD

[SOPS]

:O Firstly remember that HEAPS of people suffer from high BP, thats why there are so many drugs, (all effective, depending on your individual case) avaialble. The second thing I would say is buy your self a home monitor. Today, they are as good as the one the doctors use, and you may be surprised, you have normal BP, only goes up as medical appears. Give it ago Cheers SOPS:O

[wellthis]

HBP is the symptom of possibly many things. The top ones on the list are: Obesity, Nicotine/caffeine/alcohol, lack of exercise, Stress, and Genetics. Except for the last one, I'd say focus on the cause as opposed to the symptom.
If you say there are many that do all the above and have no problems, well they haven't reached their saturation yet, they will! Hope you don't mind my candidness :O

[gingernut]

Fox 6, without wishing to be flippant, it would appear that high blood pressure, (hypertension), is becoming as common, ( and ? as "normal"), as having grey hair, in middle and later years.

Some, would even find it difficult to class the condition as a disease, more of a risk factor, which can usually be controlled with either lifestyle changes, (losing weight, aerobic exercise, stopping smoking, limiting alcohol), or by using medication, or a mixture of both.

From a medical point of view, it can be sometimes quite difficult to convince patients to take a drug, which after all is an unnatural chemical, to control a condition which (usually) has no ill effects.

However, the research surrounding the subject of hypertension is quite unequivocal. Controlling a persons blood pressure, reduces the risk of early disease and death.

If you have high blood pressure, don't fall into the trap of labelling yourself as being "ill." The people I worry about, are those walking about with uncontrolled, (unknown), high blood pressures.

If you want to know the ins and outs of which medications mix with flying, contact your quack,

Good luck.
:O

[Whirlybird]

gingernut,

....it would appear that high blood pressure, (hypertension), is becoming as common, ( and ? as "normal"), as having grey hair, in middle and later years.


I find myself wondering how much that is due to a change in what is defined as "high". I remember a time when 100 plus your age was considered acceptable for the systolic pressure. Now, it's being said that anything over 140/90 is "high". I've even read, though I don't know if it's true, that in the US they're saying a systolic pressure over 120 is high!!!

So are we saying that high BP is a disease, or that ANY rise in BP above that of a healthy YOUNG person is a risk factor (since BP does rise with age)? If the latter, then we're condemning a high proportion of middle-aged and elderly people to taking medication for life. And while the risks associated with blood pressure medication may be low, ALL drugs carry some risk. And if it were me, I'd want to balance those risks myself. I'd want to know how high the risks are, of a now-high-but-previously-considered-normal-bp, leading to anything life threatening, before I'd take anything. That seems to me like any informed and intelligent person's response.

And I do wonder how many GPs could actually tell me the answer to that? QDM and others, what say you? (Unfortunately I'm off on holiday in a few hours and won't get the answer).

[QNIM]

Gday Fox6
My BP has been creeping up over the last 10 years, I tried to ignore it but the authority decided not to renew my class 1 last medical, so no work for almost a month, I was put through every test you could think of and at great expence. My advice is start controlling it early and you shouldn't have any more problems.
Cheers Q

[gingernut]

Whirly, hope you get this message after your hols, when hopefully your blood pressure should be at its lowest !

And I do wonder how many GPs could actually tell me the answer to that?

Well, probably quite a few actually, to a certain extenct !

The clinical decisions your GP makes will usually be based on clinical trial data, which usually includes a measure of NNT - numbers needed to treat. From what I gather, and perhaps my more learned friends could correct me if nedded, these are the number of patients, from a certain population, (eg males aged 50-60 with a bp >160), which need to be treated, by an intervention, (eg. a blood pressure drug), to prevent an adverse incident, (eg a stroke).

However there are certain problems with this approach.

a) your GP will have to generalise the trial data to his population, or to the patient sat in front of him....do you share the same characteristics as the patients used in the trial ? Most of my patients do not !

b) Some adverse outcomes, (eg. death), are very carefully monitored by the trials. However, the "softer" adverse effects, eg. is this drug going to make me impotent/tired tend to be less rigourously monitored.

c) Some would say that because of the massive amount of money involved in treating hypertension, then we can never really trust the data of the drugs companies. Remember only the positive stuff usually gets published !

d) GP's have to make decisions based on the trial data, which may not be generalised to you. The drug in question may may have worked for 4300 of the 5000 people it was tested on, but it may not actually work on you.

e)GP's are very busy people, treating a number of different conditions which affect their population. There are about 12,000 journals published annually - even the most diligent GP would be unable to keep up with every single article published regarding hypertension ! They rely on secondary sources of information to make clinical decisions. Some of these secondary sources have a low element of bias, eg recommendations from the British Hypertensive Society, others are more questionable, eg, young pretty drug company representative with flashy car, glossy mag and free clock for office.


I guess the question you are asking, is can we accurately balance risk against benefit, on your behalf. Well perhaps not with 100 % accuracy, but we use the best tools to hand, the clinical trial data.

Cheers, David.

[FBS]

I had my medical last week and since mine is not a class 1 all I really need to do is prove my ability to breathe . . .

However, I usually go to the GP beforehand to get the BP checked and they told me this year the level they consider "high" has been dropped and so wanted to put me on meds. I said No Way and I am now going to the gym. Mine is definitely weight and exercise related (Knee and back injuries mean I have to be careful) but I sailed through my medical last week without a problem and without any meds!

Added to which I will soon be looking like the Adonis that I know lurks within my present portly shape.

Girlies watch out . . .

FBS

[tony draper]

I take tablets for high blood pressure, on reading the advice note that comes in the box, I was supprised to see Hypertension numbered among the side effects??

:confused:

[gingernut]

Tony, hyper or hypo ?

[Northern Chique]

the irony of the side effects of some medications is they can mimic the effect of the symptom it is being used to treat as is the case with some anti convulsant meds, but the most common generic side effect of medication used to treat hypertension is hypotension. Hyper meaning above in this case, over an accepted figure and hypo, being below or lower than an accepted guideline figure.

Our guidelines give general normal ranges of physiological functions such as blood pressure, pulse and respiration rates etc. These have to be taken in context with the person and the situation. What is normal for some folks is extraordinary indeed! Some ECG readings Ive taken on patients have made me seat all the way to hospital, only to discover the abnormal pulse, the poor rhythm and cardiac conduction, fast pulse and low blood pressure combination are entirely normal for this patient!

Anxiety and dehydration have been known to produce abnormal results across a range of functions. Each reading should be taken in context with the total picture. As stated previously, the stress of a medical (and trying to understand the medical mutterings of a fatigued medico) with the associated taskings can be enough to raise a blood pressure. Some nurses Im told have the same effect.

A BP of 90/60 in a slight framed petite female is acceptable, whereas a reading of 150/110 in the same female would ring alarm bells, especially if other symptoms or conditions are present. The other element is the measuring equipment. An inaccurate and high reading can be gained by simply using an automatic machine and a cuff too small for the patient. Gauge errors on the typical manual machine are not uncommon, but tend to err on the low side.

If the candiate is given the option of drug free exercise and monitoring for a period of 3-6 months, and improvement is not achieved, then investigate the cause. If no other symptoms are present, it may be an early warning of arterial disease or renal stenosis (simply put, it can be described as a narrowing of the tubules that provide a physiological feedback mechanism to regulate blood pressure. Poor pressure detection and regulation in one or both kidneys may artificially drive up blood pressure). Correction of the condition may correct the symptoms.

....or as stated above, it may be just one of those hereditary things whereby the symptoms are managed and drugs may just be a part of a total management regime.

[Flyin'Dutch']

Whirly,

The answer to your question is 145/90 and above.

Those with a bloodpressure higher than this are more at risk of developing cardiovascular disease and strokes.

In coming to this cut-off for diagnosis and treatment the risks/drawbacks have been taken into consideration.

HTH

FD

[Semaphore Sam]

August 2002 I faced the same issue; BP climbing slowly thru the yrs, til finally I had to do something, after high readings during FAA medical. Maybe pill solution is necessary; I was given Dr. Atkins Diet book by a friend, I gave it a month trial before starting medicine. Can't believe my BP now, well below 120/80 for most part, while before 135/95 was the lowest I could hope for, if lucky. I'm not preaching, but it has worked for me (also HDL readings up, LDL much lower), weight loss has been an added bonus. It's worth considering; I saw change within a week and a half; beats a lifetime of pills. Sam

[scanscanscan]

Sam....I find that very interesting.
Some years ago at GF I went on what was then called the Atkins Diet.
According to the Atkins book I had to also used Ketos sticks to measure effectivness of the diet on my urine.
My British Aviation Doctor went ballistic at my six monthly renewal when he asked me if I was dieting and said he would ground me unless I ceased this diet immediately and rightly or wrongly he said Ketos production in urine was a first sign of diabetic coma.
I have no real opinion either as I have had no medical training but I felt pretty rough on this diet and suffered constipation.
However I did loose weight quickly.
Further more today the local Norfolk & Norwich Hospital here was reported in the local press not to prescribe the Atkins diet but no reason was published. From what I hear down the pub most of the blokes wives are on it and if they loose enough weight it will be worth going home sober!

[Semaphore Sam]

Hi Scan
As per subject, I just reported on salutary results on Blood Pressure, Cholesterol (HDL & LDL) levels, & weight.

Atkins discusses your doctor's concerns in his book; says ketones produced by the diet is totally different situation from diabetes. I wouldn't recommend the diet unless you read Atkins book, "Dr. Atkins New Diet Revolution", wherein he discusses this issue. Constipation does occur during induction phase, and can be dealt with.

I understand the medical and dietary establishments have said the diet is dangerous, but the diet's 30 years old, has been used by thousands, and there has been no major increase in death and calamity among users; only weight loss, lowered Blood Pressure & cholesterol levels, and prevention of diabetes. However, I am not medically qualified either; just reporting my success.