First of all, what was considered “normal” blood pressure was lowered a few decades ago (from 140 to 120) because, guess what, that means they can put you on blood pressure medicine and earn big money!
And one way to combat white coat syndrome, if you know it’s that (which I do), is to simply water or tea fast for the 2-3 days before a medical appointment and drink some tea or herbal thing thing that calms you on the day. I promise it will read 10-20mm/hg lower.
Airborne_Again wrote:
Wonderful! But I’m surprised if some of his points are not taught in medical school…
Of course they are. The thing is, MD curriculum focuses on all kinds of human psychological factors that occur on the patient side. There is nowhere near as thorough and formal appraisal on cognitive bias at the “interpretation side” as compared to what I learned in PPL and IR theory. I imagine CPL/ATPL takes that even further but I have no ambition there – maybe I’ll have a look at ATPL human performance just for the heck of it. I certainly think there is positive influence on my job from these insights and I’m sure similar observations exist for other professions.
I would respectfully argue that those claiming a healthy lifestyle is the solution to high BP or cholesterol or whatever only see part of the picture and are likewise affected by a form of bias from a personal perspective. Healthy lifestyle is key, but for many people unfortunately not enough – even for obesity more and more evidence is appearing that for some people it really is beyond their control (eg the spectacular results seen with new anti diabetes therapy in persons where nothing else worked)
Anyway holy thread drift 
Back to the original question:
Buckerfan wrote:
SO – QUESTION: If I tell my AME that my doctor wants me to take statins etc is this going to lead to him requiring me to do a full “cardiac evaluation”?The EASA document I linked earlier states that an accumulation of risk factors should prompt cardiac evaluation, high lipids are specifically listed as an example. Interestingly the FAA seems to have specifically indicated cholesterol screening is not mandatory but that is only what I found from a 1 minute Google search – you can probably get far better advice from someone with actual experience. I would go with “don’t answer what you weren’t asked” and “careful with advice from random internet guys” ;-)
Pretty strange, but must have some explanation.
Zero stress.
AdamFrisch wrote:
First of all, what was considered “normal” blood pressure was lowered a few decades ago (from 140 to 120) because, guess what, that means they can put you on blood pressure medicine and earn big money!
If by “they” you mean “big pharma” you may be right but the medical profession seems to think otherwise. A search on e.g. health.gov (the US federal government health portal) shows that they consider hypertension to begin at 140. So 139 is normal, but on the high side.
Peter wrote:
An ECG machine’s analysis software sometimes reports “enlarged left ventricle” which the AME usually disregards if the ECG looks OK otherwise, but there can be real causes. Unfortunately none of them is AFAIK cheap and quick to check.
The way to check this would be via an echocardiograph (ultrasound of the heart). The “cost” of this is usually several months (3 to 6) of waiting time at a cardiologists practice or about 150€ if you are privately insured in Germany.
LV-Hypertrophia can be a sign of dilatative cardiomyopathie, a condition where the left ventricle gains muscle mass but its muscle cells (cardiomyocytes) are consequently less well supplied with oxygen as the distances between them and the next blood vessel increases. So you get a bulkier but less effective heart and ultimately chronic heart failure which severely shortens your lifespan. @Tango , as a proper cardiologist, can probably explain this better than I, a mere anaesthesiologist and emergency physician who happened to have served on a heart failure unit for six months…
The way I was explained ECG by my AME was that what they are looking for is changes over time. One isolated ECG means little, the history means a lot.
LeSving wrote:
The way I was explained ECG by my AME was that what they are looking for is changes over time. One isolated ECG means little, the history means a lot.
That is correct as well. Unless certain changes are present such as ST-elevation, which would signify an acute myocardial infraction but then that would almost always correspond to clinical symptoms (chest pain, dyspnoea, nausea).
Lots of other EKG signs are only meaningful when reevaluate over time. Having a baseline EKG when feeling fit and healthy is therefore helpful.
alioth wrote:
You can still end up with high blood pressure, even if you get exercise and don’t eat like a pig.
Some people in my closer circle are very sportive. Which is putting it mildly. One guy regularly runs triatlon, does even super-gigatlons or what that madness is called alone, others are not far behind. Runners, no gram fat, will run after a 14 day work day the distance home as exercise, (between 12 and 30 miles) several times a week and so on. No idea what they eat, but usually few and their menue is adapted to their training schedule, lots of protein, no alcohol, no coffee, some even go vegan and do call themselves openly health freaks. They are between 40 and 60.
In their circle of sportists, they do have quite a few people who have health problems. Lungs, heart, BP, the lot. Type 2 diabetes on one of those guys, to boot! Several in that circle even jumped off deaths wagon with the help of defibrillation and thanks to the fact that they were not alone when they had their potentially fatal heart attacks. One ended up with a collapsed lung.
And then there is me, the fat lazy swine as I have been called to my face in joke and perfectly earnest by an AME, BMI36, diet like of a nutritionists nightmare who regularly on his medicals will note 120/80 BP, 60 pulse and normal cholesterol of LDL2.2 and HDL 4.1, 5.1 sugar in the morning and whatever else they check, consistently and every time. And no, I don’t feel justified or it even makes me feel better about my weight, but all it does tell me is that there is no “fairness” in medicine! And there is a lot more to it than the standard values they take out of a medical check.
Fact is, a great lot of health lore does not take into account that humans are not machines which can be connected with a data cable and their faults downloaded like a BMW engine or a Toyota Prius. Fact is that lots more people die of sudden heart failure on the tennis court on while jogging than on the sofa at home. That is not fair to all those who eat up the exercise lore and deny themselves lots of earthly pleasures in the quest for eternal fitness. As one of my friends said: “Keep jogging and training, then jump fit into the urns.” (It rhymes in German but doesn’t translate well (“Immer joggen und turnen und dann fit in die Urnen!”) )
That is no excuse for any fat swine, not anything different than the often quoted 100 year old chain smoker. But it should give those who suffer from inexplicable symptoms like high BP or inexplicably high cholesterol a bit of a pause to think “what have I done wrong now”. Most probably not much if anything. Some is genetic, some is just bad luck. Most can be cured, either by dedicated and targeted effort or, temporarily or permanently, with medicine.
AdamFrisch wrote:
First of all, what was considered “normal” blood pressure was lowered a few decades ago (from 140 to 120) because, guess what, that means they can put you on blood pressure medicine and earn big money!
Where is that? US? Here to my knowledge 120/80 is the absolute standard value? Right down the middle of US1?
But yes, lowering values to sell medicines is big business indeed. BMI is a great joker in that regard as well.
A lady friend of ours was told for years she was to fat and too high BP by her female “health coach” until she collapsed one day. In hospital they found BMI of 19 and a BP of 90 to 50 along with severe iron deficiency. It was still too much for mrs fanatic who at least had her license to kill shreddered following that and some similar events.
but its muscle cells (cardiomyocytes) are consequently less well supplied with oxygen as the distances between them and the next blood vessel increases
As in a partly blocked artery, asymptomatic until it gets blocked a bit more…
What is wholly relevant to the threat topic is that you can’t really check this stuff out legitimately. Maybe in some countries you can get stuff checked without a report going to your GP (and thus becoming available to the CAA, should they check). I think normally you have to go abroad to get tests done.
I think in Germany the CAA has no right to see your medical record. That came out of Germanwings but, surely, they will simply not issue you a medical.
