FAA Medical Exam Blood Pressure Limits: Know the 155/95 Rule

Most pilots worry about at least one number on exam day. For many, that number is blood pressure. The FAA rule is simple: your reading must be 155/95 or lower at the exam. This post explains that limit, why the doctor's office can push your numbers up, and how to talk with your AME about blood pressure medicine.

The 155/95 Rule in Plain Terms

The FAA sets one blood pressure ceiling for all three medical classes. Your systolic (the top number) must be 155 or lower. Your diastolic (the bottom number) must be 95 or lower. This applies to first class, second class, and third class alike.

If your reading is at or under 155/95, you generally meet the FAA limit. Your AME can issue your certificate that day, as long as nothing else on the exam is a problem.

If your reading is above 155/95, the AME cannot simply ignore it. They may check it again later in the visit. If it stays high, they may deny or defer your application. A deferral sends your file to the FAA for review. That review can take weeks or months. Plan ahead so a high reading does not stall your flying.

One note: the FAA standards do not state a specific number in the rule text. The 155/95 figure is the current guideline maximum. Rules and guidance can change, so confirm the current limit with your AME or check the FAA Guide for Aviation Medical Examiners before your exam.

Why Your Reading Spikes at the Doctor's Office

Many pilots have normal blood pressure at home and high numbers at the clinic. This is common. Some call it white coat stress. The setting itself raises your pressure: you are nervous about passing, you rushed through traffic, you drank coffee an hour before, or you are worried about your career.

The fix is not to hide anything. The fix is to prepare.

• Check your blood pressure at home for several days before the exam. Write down the numbers and the times.
• Bring that log to your appointment. It gives your AME real data, not just one nervous reading.
• Skip caffeine on exam day.
• Arrive early and sit quietly for a few minutes before the cuff goes on.
• Ask the AME to recheck your pressure later in the visit if the first reading is high.

A pilot in one account shared that their AME asked them to take their blood pressure every day for a week before the exam. That kind of log helps the AME see the full picture. Ask your own AME if they want the same.

What Happens If Your Reading Is High

Your AME has options. They can recheck your pressure during the same visit. If it comes down, you may be fine.

If it stays above 155/95, the AME may defer your case to the FAA. The FAA then reviews your file. You may need to show home readings, treatment records, or a note from your treating doctor.

High blood pressure itself is not an automatic disqualifier. The FAA cares about whether your pressure is controlled. Many pilots with hypertension hold valid medical certificates. The key is showing control, not perfection on one reading.

If you already know you have high blood pressure, do not wait until exam day to deal with it. Talk to your regular doctor first. Get your numbers stable. Then book your FAA exam. For a step by step walk through of the visit itself, see what to expect at your exam.

Blood Pressure Medicine and the FAA

Can you be an airline pilot on blood pressure medication? In many cases, yes. The FAA allows many common blood pressure medicines. But not every drug is accepted, and the rules depend on your class and your history.

This is where the conversation with your AME matters most. Before you start a new medicine, tell your AME what your doctor wants to prescribe. Some medicines are fine. Others need extra steps, such as a waiting period or a Special Issuance.

Do not stop or change a medicine on your own just to pass an exam. That can be unsafe and can create a bigger problem with the FAA. Instead:

1. Call your AME's office before your exam and say you take blood pressure medicine.
2. Ask whether your specific medicine needs extra paperwork.
3. Ask if your case can be handled on the spot or needs FAA review.
4. Bring your prescription list and any recent doctor notes to the exam.

Some cases can be handled by the AME directly under FAA programs that let them issue for certain conditions. Others go through a Special Issuance, which is the FAA's process for granting a certificate with a condition that does not meet the standard. Our Special Issuance guide explains how that path works.

Medicine names, accepted lists, and waiting periods can change. Confirm your specific drug with your AME or the FAA before you rely on it.

Prepare Before You Book

A little planning can save you weeks. Here is a simple routine:

• See your regular doctor if your home readings run high. Get treatment started early.
• Track your pressure at home for at least a week before the exam.
• Fill out FAA Form 8500-8 in MedXPress before your visit and bring the confirmation number. The application stays valid for 60 days. Answer every question truthfully. A false answer is a federal offense.
• Call the AME's office and ask about blood pressure policy, medicine paperwork, and the current fee. AMEs set their own fees, so prices vary by city and class.
• Bring your medicine list, home readings, and any doctor notes.

If you are not sure which class you need, read FAA medical classes explained first. Some private pilots may qualify for BasicMed instead of a traditional medical certificate. Our BasicMed vs third class post covers that choice.

Find an AME Who Knows Hypertension Cases

Not every AME handles high blood pressure cases the same way. Some are more experienced with the paperwork and the FAA review process. It is fair to ask questions before you book.

When you call, ask how often they see pilots with hypertension. Ask how they handle a high reading on exam day. Ask whether they can issue on the spot for your situation or whether they expect a deferral. Their answers will tell you a lot.

You can start with our directory to find an AME near you. If you live in a large state, these pages may help: Aviation Medical Examiners in California, Aviation Medical Examiners in Texas, and Aviation Medical Examiners in Florida. Our ranking method explains how we list AMEs. We are an independent directory and not affiliated with the FAA, so always confirm details with the clinic and the FAA.

Key takeaways

• The FAA blood pressure limit is 155/95 or lower for all classes. Confirm the current guideline with your AME or the FAA Guide for Aviation Medical Examiners.
• Nervousness at the clinic can raise your reading. Check your pressure at home for several days and bring the log.
• High blood pressure is not an automatic disqualifier. Controlled pressure with the right paperwork is often certifiable.
• Many blood pressure medicines are accepted, but not all. Tell your AME before you start a new drug, and never stop a medicine on your own.
• Prepare early: see your regular doctor, fill out MedXPress, and call the AME's office about fees and medicine rules before exam day.