Lisinopril for the Treatment of Hypertension in Aviators

摘要

Hypertension affects 1% of USAF aircrew. Pharmacologic treatment options in the USAF have been limited to diuretics. Lisinopril is an angiotensin converting enzyme (ACE) inhibitor shown it to be safe and effective for treatment of hypertension with minimal side effects. Methods: Ninety-four aviators with essential hypertension were evaluated. Testing included audiologic, vestibular, ophthalmologic, laboratory and G-tolerance testing as well as coronary artery disease (CAD) screening. Results: There were no significant abnormalities detected which were directly attributed to lisinopril. Echo abnormalities were found in about 30% and led to disqualification in three aviators. Twenty-four aviators underwent cardiac catheterization due to positive noninvasive tests and 13/24 had gradable disease. G-tolerance was not significantly decreased in the 22 aviators who underwent centrifuge testing assessed by comparison to control group of normal aviators. Test results were used to construct an algorithm approach to local evaluation. Conclusion: The extensive central evaluation done on these aviators failed to detect aeromedically significant side effects associated with lisinopril for the treatment of essential hypertension. With the exception of G-tolerance testing for high performance aircraft aviators, all other testing necessary for initial and subsequent annual examinations can be done at the local level.