AVIATION MEDICINE

The Federal Aviation Administration is charged with ensuring the safe conduct of aviation for both pilots and the general public. The primary concern from the perspective of the FAA is incapacitation of pilots during flight operations from sudden cardiac events. Since hypertension is an easily identified and treatable risk factor for sudden cardiac events, the FAA focuses on aggressive identification and treatment of this condition.

Hypertension – or high blood pressure – is a very common condition in the United States. Some studies suggest that up to 28 percent of the population may have some degree of hypertension. There is a strong, continuous and graded relationship between hypertension and cardiovascular events such as angina and heart attack.

In chronic untreated hypertension, a condition develops called left ventricular hypertrophy. In other words, the heart muscle has to work so hard constantly that it enlarges and thickens abnormally. This condition further increases the risk of deadly cardiovascular events.

If there is poorly controlled hypertension, the applicant’s medical certificate may be deferred by the Aviation Medical Examiner until adequate hypertensive control is documented and provided to the FAA in Oklahoma City.  Many of the FAA-employed physicians are also aviators and are sympathetic to those who wish to fly, and will work hard to get as many pilots safely in the air as possible.

If the high blood pressure has been previously identified and is well controlled by the primary care physician (PCP) then, per the FAA, yearly follow-up is needed for first and second class airmen. For third class airmen follow-up is needed only at the time of renewal of the license.

When visiting your Aviation Medical Examiner for a medical certificate, remember to do a little preparation ahead of time to streamline the process. Specifically, if one has a chronic medical condition(s) requiring regular use of medication(s), get a letter from your PCP confirming that the condition is well managed, stable and under control.

In the case of hypertension, provide a letter from the treating PCP showing good control of blood pressure, absence of side effects from medication, and no other significant cardiac risk factors.

Dr. Richard Gayles

Happy Flying!

Dr. Richard Gayles is a graduate of the University of Michigan Medical School.  After obtaining his medical degree, Dr Gayles completed a residency in anesthesiology at The Johns Hopkins Hospital in Baltimore, Maryland.  Subsequently, he held the post of visiting registrar at St. Bartholomew’s Hospital in London.  Upon his return to the United States, Dr. Gayles completed a fellowship in chronic pain management at the Cleveland Clinic in Cleveland Ohio.  Dr. Gayles is an Aviation Medical Examiner (AME) and a multi-engine instrument rated pilot. His interest in aviation led him to recently join Angel Flight, a volunteer organization which transfers chronically ill patients across country via private aircraft.

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