Predicting Hypertension in Polish Military Pilots with High-Normal Blood Pressure

High-normal blood pressure (HNBP) is associated with an increased risk of progression to hypertension (HT), which may have implications for aeromedical certification. This study aimed to determine the rate, timing, and risk factors for progression from HNBP to HT in active-duty military pilots.

We retrospectively analyzed medical and flight records of 1523 active-duty Polish military pilots, identifying 147 men with HNBP. Data included annual medical evaluations, risk factor assessments, and the type of aircraft flown. Kaplan-Meier estimators and Cox proportional hazard models were used to evaluate progression to HT and associated risk factors.

HT developed in 46.9% of pilots with HNBP within a mean of 4.5 ± 2.2 yr. Obesity was the only atherosclerotic risk factor significantly associated with HT progression. Pilots of supersonic and rotary-wing aircraft had a higher HT risk after age 32 compared to those flying subsonic or transport aircraft.

High-normal blood pressure progresses to arterial hypertension in approximately 50% of men, regardless of age, within an average of 4.5 yr. In individuals with HNBP, the presence of obesity increases the risk of HT development threefold for approximately 3.5 yr. Adverse environmental factors associated with flying helicopters and high-performance aircraft constitute an additional risk factor for HT progression in individuals with HNBP. The aeromedical regulatory guidelines need to be updated to include recommendations and decisions concerning military pilot candidates with HNBP. Zawadzka-Bartczak E, Robert D, Lech K. Predicting hypertension in Polish military pilots with high-normal blood pressure. Aerosp Med Hum Perform. 2026; 97(2):93-99.