Question about BP

M

Mpeavler

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Mike Peavler
I've got a question regarding blood pressure for 2nd and 3rd class meds. I currently have a 3rd class but was finishing up my desire for adding a commercial rating to add to my PP/IR rating. I frequently get questioned about my BP because when I visit doctors I get the "white coat" effect which raises my BP a few points. I work in a semi stressful job now and I've noticed since the change in jobs, the BP has increased. I've not had a problem with receiving my 3rd class from numerous docs but as mentioned they ask me about it.

Now....that I will need a 2nd class to use the commercial rating here is my question. When I'm at home....my BP after I relax is fine...and often right at 120/77 vs the normal visit of 150/90 ish when I visit the doctors. Is this going to be a problem? If the pressure is to high for them and they were to put me on medicine to lower it...does it impact medicals?

My other concern is once I was given a "sample" after visting my past doctor. I tried to explain that I had 5 days of cold/flu medicine in me and it's likely why at that time it was 152/94 but she insisted. After only 12 hours of the "trial" I had some horrible reactions of which left my heart beat at like low 40's when I relaxed and VERY low BP. I decided on my own after 4 days of trying this "trial" that I was not going to take it again and even called the doctor and told her of my horrible symptoms from it. She said she wanted to try a different level....of which I said NOPE. I checked my BP after a few more weeks....and it was 117/74 after I had watched a movie with my wife w/out the meds.

What's everyone's thoughts on my questions? I hate to commit to spending the $$ to do the commercial rating if my BP will become an issue. I did check it last night and it was 122/84

For what it's worth....I've only been to the doctor 2 times in 3 years.....and am very healthly overall. Those 2 times were for a knee injury and a strep throat.

Take care,
Mike
 
Check your BP at work sometime. If its cool, fine. If not, there are lots of medications. High BP is a bad thing to ignore, as it can lead to lots of bad cardiovascular stuff. Can't fly big shiny spanky airplanes if you've stroked out.
 
Mpeavler said:
Well....I only run into issues really when I goto the doctor. Does being on BP meds impact medicals?
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Depends. Vne for BP is 155/?? i forgot the lower number. You can be on blood pressure meds to control the pressure and still get your medical.

-Skip
 
Mpeavler said:
Well....I only run into issues really when I goto the doctor. Does being on BP meds impact medicals?
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Yes! You may get the medical, but first ...


At the time of the first application for medical certification after starting blood pressure medications, you should have available for the aviation medical examiner a current cardiovascular evaluation that includes:
  1. A report of pertinent personal and family history, including an assessment of risk factors for coronary heart disease; a clinical examination that includes at least three blood pressure readings; a summary of medications and dosages; and statements regarding any side effects. AOPA has a Hypertension Evaluation Worksheet that your doctor can fill out to fulfill this part of the evaluation.
  2. A resting electrocardiogram (done within the preceding 90 days).
  3. A current(within the preceding 90 days) laboratory report of fasting plasma glucose, blood lipids, including total cholesterol, HDL and LDL, triglycerides. If diuretics are being taken, potassium and creatinine levels are also required.
For recertification at the time of your next medical renewal, you will need a brief report from your treating doctor, including a summary of current medication and dosages, three blood pressure readings, and if taking a diuretic, a current serum potassium level.
 
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Thanks for the responses....I guess I'm at a loss because when at home and not nervous about being at the doc....my BP is just fine. I don't want to make this an issue if in fact it's not except when seeing the "white coat" effect ya know. It sounds like a bunch of extra work, money and steps when normally I'm good /shrug

M
 
maybe tell them about the white coat syndrome - see if they'll let you lay down or spend a few minutes of deep breathing, relaxing, meditation, whatever to see if you can bring it down again ... I can drop mine more than a few points just by taking a few minutes of relaxing and breathing
 
I still say check your BP at work. If your job is sufficiently stressful to raise your BP you could have a significant medical problem.
 
Well....that's what I do when I go ...I just let them know I'm really nervous because there is a lot on the line when it comes to the Medical and all. I've had a first class medical for years....but switched this last time through to get more duration.

M
 
Mike,

FWIW, while not a medical physician, I have had in the course of my clinical practice as a police psychologist to work with folks w/ high BP, amongst whom were those with "white coat syndrome." "WCS" is not a figment of anybody's imagination - it's real. As i've posted before, the context in which BP is assessed is extremely important in terms of the accuracy of the reading.

E.g., expect higher readings if you are being talked to by the nurse or the doc while the reading is being taken; also, if you are in a stressful life circumstance, ditto; as well, if you have been a chronic, chronic taker of Motrin, Advil, Ibuprofen; and, not least, but probably most important, how the BP is taken: 5 minutes rest, nobody in the room, no conversation, nada, zip; quiet, restful breathing, and then: first reading taken, after which elevate pressure arm to near vertical, wait one minute, retake for reading #2; repeat for reading #3 and then take the average of those readings. A first reading, and if it's the only one taken, will almost invariably be the highest. Most medical docs and nurses don't know of this protocol. (It's not mine, it belongs to <www.dynapulse.com> and I'm not a recipient of any funds from them).

I'd recommend that you spend a couple hundred bucks, by Dynapulse's Home system (make sure you get the correct size cuff); hook that puppie up to your computer, record your BP according to the aforementioned protocol, print out the recordings - which will be date and time stamped - and which will include a trace of the pressure wave as well as readings of systolic pressure, diastolic pressure, mean arterial pressure and heart rate. The dynapulse site will also reiterate the standardized protocol for acquiring the BP data.

When you've got these printouts, carry them into your examination, show them to your doc and say "This is what my BP looks like in my normal life."

HTH

tony
H. Anthony Semone, PhD
Police Psychologist
 
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I have the exact same problem. Whenever I go to the doctor, my BP is always surprisinly high. My personal record was 148/98 or something like that. Now I always tell them before they take it that they're in for a surprise. Then they take it and become very quiet :)

My AMEs always took the BP a few times after the initial reading indicated high BP. Interestingly enough, I've never had my BP taken the way I understand it is to be done. I'm sure that has something to do with it being high. I'd just let the AME know that you always have high BP at a doctor's office and that he'll have to take it at the end of the session.

-Felix
 
Well....so far no issues in 14 years....including many years carrying a first class med. They usually ask me..."are you nervous"....I'm like yep....and it goes from there

M
 
Mpeavler said:
Well....so far no issues in 14 years....including many years carrying a first class med. They usually ask me..."are you nervous"....I'm like yep....and it goes from there

M
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Mike, we've got long term data saying that guys with "white coat" syndrome develop Heart attack and Stroke at a rate similar to those with plain out untreated hypertension.

Wherease you can use short term rapid isometric relaxation to bring it down a few points, reread that first paragraph. If you want a nice healthy retirement, work on it now. Get it controlled. Besides, we also know that <130/<80 results ina ANOTHER twofold reduction in heart attack and stroke.

Controlled Hypertension is something that ANY AME can issue in the office with a letter from the doc, an EKG, Fasting lipids, creatinine, and Glucose. Except for the doc's letter, these are one time only.

Reread paragraph #1. :yes:
 
gkainz said:
maybe tell them about the white coat syndrome - see if they'll let you lay down or spend a few minutes of deep breathing, relaxing, meditation, whatever to see if you can bring it down again ... I can drop mine more than a few points just by taking a few minutes of relaxing and breathing
Click to expand...

And get them to check the blood pressure BEFORE the prostate exam...
 
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