Hypertension and aeromedical considerations

Mahmud  momenzadeh; Ahmad  ebadi; Reza  eslami; Amir  khoshvaghti

Annals of Military and Health Sciences Research

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Hypertension and aeromedical considerations

Author(s):

Mahmud momenzadeh^1,*,

Ahmad ebadi²,

Reza eslami²,

Amir khoshvaghti³

1Researcher, Aerospace and subaquatic medicine school, AJA University of medical sciences, Tehran, Iran, Andorra

2Researcher, Aerospace medicine research center, Aerospace and subaquatic medicine school, AJA University of medical sciences, Tehran, Iran, Andorra

3Assistant Professor, Aerospace medicine research center, Aerospace and subaquatic medicine school, AJA University of medical sciences, Tehran, Iran, Andorra

Annals of Military and Health Sciences Research:Vol. 11, issue 4; e65022

Published online:Oct 28, 2013

Article type:Research Article

Received:Jul 21, 2013

Accepted:Sep 28, 2013

How to Cite:Mahmud momenzadeh Ahmad ebadi Reza eslami Amir khoshvaghtiHypertension and aeromedical considerations.Ann Mil Health Sci Res.11(4):e65022.

Abstract

Background: Hypertension is the most prevalent risk factor for arterial disease in the industrialized world and is a frequently encountered clinical problem in the aircrew population. Arterial systolic and diastolic blood pressures are continuously varying quantities, influenced by a host of extraneous factors. Aviators with hypertension responsive to life-style modifications should have serial BP rechecks quarterly to semi-annually during the first year to assure success of the lifestyle modifications. Failure to achieve blood pressure control with lifestyle modifications, or an initial blood pressure average exceeding 160 mmHg systolic or 100 mmHg diastolic, requires initiation of pharmacotherapy. Material and Methods: In this study we evaluate books, magazines, articles ، guidelines and reliable websites related to aeromedical concerns and waiver considerations in aircrew with hypertension. Results: Two major “types” of essential hypertension are generally recognized. One is characterized by suppressed renin activity and sensitivity to dietary sodium, the other by high renin activity and a lack of response to sodium intake. Thiazide diuretics are certainly the initial therapy of choice, particularly for older subjects. Aircrew with blood pressure that is controlled adequately with thiazides, with no other uncontrolled cardiovascular risk factors, and with no evidence of end-organ damage, are usually fit to return to unrestricted flying in military and civilian spheres. ACE inhibitors are an alternative initial choice in younger aviators, are positively indicated in patients with type 2 diabetes, and have no adverse effects on serum lipids. Conclusions: Hydrochlorothiazide (hctz), with or without triamterene or potassium replacementt, can be used as a first line agent for treatment of hypertension in designated personnel. ACE inhibitors might have an adverse effect on G-tolerance have not been borne out by experience in either the US Air Force or the Royal Air Force (RAF), and the US Navy accepts these agents for unrestricted flying without G-tolerance testing.

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