Hypertension and orthostatic hypotension in applicants for flying training and aircrew

Although blood pressure standards in aircrew members have been revised periodically over the past 70 years, hypertension still remains one of the most controversial problems in aviation medicine. Improved clinical knowledge and operational experience vindicate a more liberal attitude for acceptable blood pressure levels. Applicants for flying training presenting labile hypertension may be accepted. Also, experienced, older aircrew with benign hypertension controlled by drugs without adverse reactions and without target organ disease may remain on flying status. In order to avoid compromising flight safety, long-term monitoring of flight crew for the diagnosis of hypertension together with the evaluation of anti-hypertensive drugs in aircrew is urgently required.