Controlling Your Blood Pressure

By Richard R. Grayson, M.D.

Senior Aviation Medical Examiner

Geneva, Illinois



            A pilot came to my office for his flight physical one morning with a blood pressure of 184/120.  He had no previous elevations of blood pressure. Upon questioning him, it turned out that he had a big argument with his 17 year-old daughter just before he left the house. He was still enraged.  The next day and ever since then his blood pressure was normal.   

            One of the most common discrepancies that might ground you at the flight physical is your blood pressure.  You might have to negotiate an FAA aeromedical obstacle course after that, so let's review a few pearls of information.

Blood pressure tips:

  • Look up white coat hypertension. Some people have a phobia for the doctor’s office and it raises their blood pressure beyond the normal range.
  • Buy your own automatic digital battery operated blood pressure outfit (sphygmomanometer) and do your own testing at home.
  • Get the kind that goes on the upper arm, not the wrist or finger.
  • Choose the type that blows up the cuff automatically. 
  • If you have a large arm, you might need a large cuff.
  • Take your blood pressure repeatedly over 5-10 minutes if high.
  • Breathe deeply.
  • Relax your arm.
  • Anxiety releases adrenalin and raises the blood pressure
  • Normally nobody ever thinks of margin of error when measuring blood pressure because the blood pressure varies from moment to moment.
  • I always tell folks who have a home machine to bring it to the office and calibrate it against the doctor's machine. Theoretically, an old fashioned mercury manometer is the gold standard, not the aneroid type.  I used to have a metal "Y" tube to channel the cuff air to two gauges simultaneously to see if both gauges were the same.  Meanwhile, there is a good article on blood pressure in Wikepedia which will surprise you with the notion of intra-arterial versus ambulatory recordings.  

Questions and comments welcome: