New hypertension medication before Class 1 renewal
Captain C, 52, holds an IR(A) and a Class 1 medical certificate valid until 20 December 2025. In September 2025 he was diagnosed with hypertension. His initial blood pressure was 150/95 mmHg; after four weeks on amlodipine 5 mg once daily it is 132/84 mmHg. He has no symptoms, no chest pain, no shortness of breath, and no evidence of end-organ damage. He feels well and has no side effects. He has a four-day trip starting on 1 November 2025 and wants to know whether he can fly before his medical renewal. He has not yet told his AME about the diagnosis or the medication. He believes that because the blood pressure is now normal and the drug is common, he can continue as normal until December.
1. Can Captain C continue to exercise IR privileges on 1 November without further medical action?
Read the worked answer
No. A new diagnosis and the start of regular medication are changes in medical fitness. Under Part-MED, the pilot must not exercise the privileges of the licence if aware of any decrease in medical fitness, and must seek the advice of an AME. The existing certificate does not automatically authorise him to continue after a new diagnosis and treatment. He should not fly until the AME or medical assessor has reviewed the case and confirmed fitness. The fact that the blood pressure is controlled and the drug is common is relevant to the eventual decision, but it does not remove the notification and assessment requirement. The safe and compliant course is to contact the AME before the 1 November trip and follow the advice given.
2. What will the AME assess, and what is the likely outcome for Class 1?
Read the worked answer
The AME will assess whether the hypertension is controlled, whether there is end-organ damage, and whether the medication is acceptable and free of side effects. Amlodipine is generally acceptable for flight crew, but the underlying condition and the treatment need to be documented. The AME will review blood pressure readings, investigations, and a cardiology or GP report if needed. If the condition is stable, controlled to an acceptable level, and there is no end-organ damage, certification is possible. The medical assessor may issue the certificate with a limitation requiring periodic blood pressure review. The pilot should not self-certify, and he should not treat the normal reading as proof that no assessment is needed.
3. If cleared, what practical conditions should he expect?
Read the worked answer
He should expect to provide follow-up blood pressure readings and possibly a report from his treating physician. The certificate may be issued with a limitation or a requirement for regular review. He must report any change in medication, side effects, or worsening control. He must also continue to meet the general fitness requirement before each flight. If the AME refers the case, the delay may affect the 1 November trip; he should plan for that and not assume clearance. The key point is that clearance is an aeromedical decision, not a personal judgement based on a good blood pressure reading.