ABSTRACT
Hypertension (HTN) affects over 1 billion individuals globally. Aircrew with HTN should have overall cardiovascular risk assessment using a validated risk-score calculator. HTN is often one manifestation of multiple interrelated cardiovascular risk factors: whole system approach is required, weight loss and exercise program may prevent the need for pharmacological intervention, even in a healthy population such as aircrew. HTN associated with increased risk for myocardial infarction, heart failure, atrial fibrillation, chronic kidney disease, cognitive decline and premature death. Aircrew with HTN must be treated as having a significant, but usually modifiable, cardiovascular risk factor. Caution is advised when selecting the most appropriate pharmacologic agents to treat HTN in aircrew. Alpha-blockers, loop diuretics, adrenergic blocking agents and other centrally acting agents should be avoided due to risk of unpredictable postural and central effects. Most classes of modern antihypertensive agents are deemed compatible with continued flying.
