Blood pressure questions

[Guest wtn001]

F16md I appreciate your answering my question a few weeks ago regarding my doctor prescribing me the blood pressure medicine; even though the response was not what I hoped. I have since been having blood pressure checked at both the doctor's office and my own personal machine I bought(while off the medecine), and it has been normal My aunt is a pharmacist and good friends with the local hypertension specialist. If he says that I don't need the medication, and that the other doctor's decision was hasty. What are my chances of being passing the physical. I have only been on the medication for two months and I saw in the regulations that you included in your response; it said CHRONIC use of medication.

Appreciate your time

Best of luck to everyone

[Guest F16PilotMD]

If you only took this medication for a short time and all parties agree it was a "mistake" I wouldn't even mention it. I can't remember how long you said you took it, though. If I were doing your IFC1 and it was a month or two and your BP is good off medication for my exam....I'd forget it and write it off to a mistake/misunderstanding.

If you were on it for six months, that's a little tougher to "forget".

If you notify them you took it, you will then likely be asked for all the documentation (when diagnosed, what meds, how long, what effect the meds had....)

These situations are not covered in the regs. It's all or nothin'.

If I recall, you said your BP was 140 over something. That's not even "high" by reg...it's the upper limit of normal...

Let me know the details again and I can give you a better opinion.

[Guest wtn001]

When the doctor prescribed me the medication, it had been 140 over 92 and some where around the same the visit before that(about a month elapsed between the two visits). My doctor prescribed me the medication in late March. I am a very bad pill taker anyway and forgot to take the medication most days. I took my blood pressure this morning with my machine and I believe it was 134 over 88(off the medication). I going to stop by the doctor's office later today and get them to check it as well. I will let you know the results. Again thanks for your time

[Guest jtpuro]

Related question: How much can your blood pressure vary from day to day or week to week?

[Guest F16PilotMD]

High blood pressure, or hypertension, in pilot applicants is defined as systolic (top number) greater than 140 or diastolic (bottom number) over 90. Both are averaged over 5 days of consecutive blood pressure checks. Your doctor jumped the gun. Some primary care docs believe that you should "treat" anything over 130. Well, "treat" for you would NOT be medications as the first-line attempt. It would be dietary and lifestyle changes, including an aggressive exercise program, etc. From what you tell me, YOU DO NOT HAVE HYPERTENSION.

There is no good answer for how to deal with this in the regs so it comes down to flight doc common sense...which you hope is followed by AETC/SG common sense when they approve your physical. You have three options as I see it.

One is have your doctor measure your BP every day for five days and have him document the results and (if you are normal) have him document the fact that he was wrong and your previous 140/92 was likely due to anxiety (so called "white coat syndrome") etc. Then you hope that the USAF buys it IF you admit it ever happened.

Two is find another doctor. Tell him/her that you are going to apply to UPT, etc and would like a physical to see if you're okay. Do not mention the BP issue from the other doc. The idea is to have a civilian doc with an unbiased history check you out. Now at least you DO have a civilian medical record stating you do not have hypertension.

Your third option is to forget it ever happened.

The integrity warning flags go off but look, just because some dumbass does the wrong thing for you and labels you with a diagnosis doesn't mean he's correct. How far you carry that logic...as I usually say, let your conscience be your guide.

The bottom line for ME is you were never really 'ON' a medication for this condition and your BP is not higher than 140/90. In my opinion, you do not have a condition that puts anyone at risk and you are not violating the intent of the regulations. The end.

[Guest F16PilotMD]

jtpuro, your BP can vary dramatically over time. How much? It depends. Everyone is different and there is no "normal" amount that I know of. There is at least one other doc on this board (Jordan, I think)...he/she may have thoughts on this.

[Guest wtn001]

Appreciate you time and patience F16md

[R-Dub]

Hey all,

I'm pretty new to this message board, but I've got a question before my FC1 in a few months (Apr 2005). When I got my DoDMERB physical done in 2001, everything came out fine and I was labeled PPQ. Since then, however, every once in a while, I have a slightly high blood pressure reading (over 140/90), and other times I'm right in the middle (very close to 120/70). Is there anything I can do to get a more stable reading along the 120/70 reading, not just for my FC1, but for my long term health and lowering my risk for heart disease later in life?

Thanks in advance.

[Guest JoeMama]

Originally posted by RWaller52:

Is there anything I can do to get a more stable reading along the 120/70 reading, not just for my FC1, but for my long term health and lowering my risk for heart disease later in life?

To lower your blood pressure, increase aerobic exercise, don't smoke, don't drink alcohol, cut back on caffeine, eat a low sodium diet, and make sure you're at your ideal body weight. Of course, that doesn't guarantee that you'll never be hypertensive, but it'll certainly help.

As far as lowering your risk for heart disease, all of the above (and keep your blood pressure controlled with meds if/when it becomes necessary), and make sure you get appropriate cholesterol and diabetes screening.

Finally, choose your parents wisely. If either of your parents had heart attacks at a relatively young age, you are at higher risk for heart disease, making it more important to control all the risk factors mentioned above.

[ 31. December 2004, 21:02: Message edited by: Jordan ]

[Guest F16PilotMD]

Your spikes in BP are probably more from anxiety than anything else. The only "cure" for that is to relax. Some people with this so called "white coat hypertension" have to do a week of BP checks in an attempt to get a "real" BP. Relax is my only advice.

[herkbum]

Hey F16PilotMD,

Are there BP meds that are OK for flight? I heard there might be 1 or 2 now. This will probably be a player for me in a few years (family history). Controlled now thru exercise. Thanks.

[Guest JoeMama]

As far as I know, the AF allows thiazides (HCTZ or Triamterene), and if your blood pressure is not controlled with either of those meds, you can get a waiver to add lisinopril (but I think you need to be tested in the fuge first).

[Guest F16PilotMD]

In general, that's correct. The list of approved medications changes from time to time. The required "hoops" to jump through for each drug (i.e.: 14-day grounding, centrifuge, etc) are outlined pretty clearly. For most, it's not a problem if you are already rated. For IFC-1 applicants--diff'rnt story.

Most people can control BP with lifestyle modifications as outlined above by Jordan.

[shiznitobam_allstars]

On my FC1 I had BP readings of mid-140's/high-80's. That totally sucketh. Had to do the 5-day blood pressure thing. 120's over 70's was the result, my doctor kept asking why I was there. For me, it was the stress of the FC1. Just try to relax.

[R-Dub]

Of the medications listed above that are approved for use in the AF, are any allowed to be taken before a person commissions?

[Guest F16PilotMD]

Can't find anything in the reg or waiver guide about hypertension on the IFC-1 physical. My suspicion is that this waiver will not be look upon favorably because it is an indicator of future health problems that the USAF does not want to inherit and pay for.

[Guest Tlicious1020]

This is going to sound crazy but I'm an Air Force student on a Navy base. I'm currently flying T-44s. My flight doctor is claiming my blood pressure is 138/92. Which is considered hypertension if its over 140 or 90. I have my own blood pressure machine at home and the results I'm getting at home is way different from the flight doctor. I feel a huge burden is off of my shoulders when I'm away from the doctors office.

Personally, I'm very fit and I know I have white coat syndrome for sure. I eat fruits and veggies like there is no tomorrow but when I step in the doctors office my nerves gets the best of me. What will a flight doctor do? If I show the flight doctor the readings from my blood pressure machine at home will he still try to put me on blood pressure medication?

[ 03. January 2007, 15:10: Message edited by: Tlicious1020 ]

[Guest F16PilotMD]

Probably (s)he will do a multiple-day BP check at the clinic. If they try to treat you without that, they are wrong.

You need to relax. Been there and done that. Did the 5 day check, etc, etc. Relax. It can be done.

[Guest awfltdoc]

Was the blood pressure in the flight med clinic automated or manual?

We have an automated b/p machine but I always insist on manual blood pressure for the five day checks. Some times the automated machines read falsly high.

[Guest F16PilotMD]

Good point aw. No question about it, the automatic things are not accurate. Some people are not accurate either, however....

Edited October 20, 2008 by F16PilotMD

[Guest Tlicious1020]

Actually Awfltdoc, this is what I did:

I walked on a treadmill for 1 hour before I went to bed. Then I got up in the morning and I walked for 1 hour at least 2 hours before I went to the doctors’ office to have my blood pressure checked. My pusle was high but my BP was 124/82. How do you go from 138/92 one day to 124/82 the next I don't know. I know the BP machine I have at home never reads high so I know I have white coat syndrome. And the nurse did the BP check manually.

[ 04. January 2007, 11:33: Message edited by: Tlicious1020 ]

[Guest awfltdoc]

Originally posted by Tlicious1020:

How do you go from 138/92 one day to 124/82 the next I don't know. I know the BP machine I have at home never reads high so I know I have white coat syndrome. And the nurse did the BP check manually.

Your blood pressure fluctuates normally. There is constant correction by your body by the kidneys to maintain your blood pressure, electrolyte levels, hydration state, etc. It is a highly dynamic system with constant corrections being made. Its kinda like flying fingertip formation, you maintain your position on the wing by constant small inputs to the flight control system by the pilot. Anyway, it sounds like your gonna be okay.

BTW, your b/p wasn't all that high in the first place. However, new research is showing that controlling blood pressure, lipids, blood sugar decreases mortality for all causes. More to come in the future based on ongoing research.

BTW #2 hehe, During the G-X your blood pressure is likely up in the 200 mmHg + range to drive blood to the nugget to maintain conciousness. This is perfectly okay for short durations.

[Guest jhk1220]

I've had a couple of bp readings recently that seem a little out of whack.

The last four, taken over 2 weeks, were:

149/81

142/83

160/80 (I was freaking out for this one)

143/86

I know I have white coat syndrome...I can even "feel" it on some visits. But I've been guzzling fruits and veggies, and eating at most one piece of lean meat a day(chicken or pork). I've been PTing for 30 minutes a day for 4-5 days a week. I'm wondering why there appears to be no progress...these were MAJOR lifestyle changes from me. I've also gone completely off the booze.

But mainly what confuses me is that my systolic consistently is high, while the diastolic is always within limits. For people who are actually hypertensive, aren't both usually above limits?

Should I consider dropping some coin on getting a private practice to take a look at me? My university health clinic isn't being too helpful with this...I need a medical letter attesting my bp is normal for me to move on to MEPS...I was an idiot and told them about a single high bp reading I've had in the past, taken when I had the flu.

[Guest cbire880]

What are you using to get that measurement? Everytime I use one of those machines at Walmart, it gives me readings like yours. If I have a qualified human being check it the old fashioned way, I always come out pretty close to 120/80.

[Guest jhk1220]

Been read at a health center by a nurse, or by one of the machines they have there...