High blood pressure and getting hired

[gaFIRE1]

I have border line high blood pressure. I almost always have it under control on my own. However, now and then it raises, especially when my white coat syndrome kicks it. I will have a physical test coming up and they will take my blood pressure before I can test. In the past, I almost lost out on the chance to take the test because my blood pressure skyrocketed. I was nervous and of course the white coat syndrome kicked in full force. Thankfully they were very kind and retook it a few times until I was able to just barely get it within allowable limits. I don't want to miss the chance to take the physical test that is coming up so I am considering getting the medication to lower it, although, I keep a log of my blood pressure and am not sure I truly need the meds at this point. My real question is, will taking the meds alert them that I have high blood pressure and completely throw me out of the process due to a health risk or is it better to take the meds and have it completely under control? Thanks in advanced for your opinions!

[johnsonizzle]

Just curious, how do you know it's White Coat and not just chronic? Did you do all the home studies required for the actual diagnosis or have you just done it on your own several times? They were actually talking about that syndrome on Doctor Radio (XM 119) last week and said that for a true diagnosis, the person would need to be hooked up to an automated BP cuff that would take their BP several times throughout the day while they're at home and then compare that to the clinical BP readings. Sounds very interesting.

This is just a stab in the dark because I'm a candidate too - but I would think that high blood pressure under stressful situations or during anxiety would be a huge risk in firefighting or EMS, even moreso than chronic hypertension due to obvious stressors of the job. Statistically, a large percentage of LODDs are due to heart attacks. Seems like a dangerous situation to place yourself in.

The reason I say White Coat might be more dangerous than chronic hypertension is because at least chronic hypertension is usually stable and can be treated with meds, whereas if it's situational hypertension you wouldn't really treat it until the onset of sypmtoms which may be too late... Just thinkin out loud here.... Good luck to you whatever you do.

[gaFIRE1]

I have never done a true home study where I am actually hooked up to a cuff for a few days. I did have HBP in the past but was able to get it under control with diet and exercise. It is still borderline. It is usually fine, although on occasion rises, when I check it on my own at home and on the machines at stores. I know my doctor will prescribe me meds if I want. I work VERY hard to keep it within normal limits on my own. I can't stray a bit off track from my diet and exercise. It is hereditary in my family and really there's only so much I can do. However, I can control it on my own as long as I don't stray a bit. On the one hand, I prefer to keep it under control on my own and on the other, it would be nice to not have to be so very careful and have meds to help. I just don't look forward to depending on meds for the rest of my life. I have thought about the fact that maybe it would be better to go ahead and take the meds, especially if I do get hired. I would especially want it completely under control in those situations. I have taken my blood pressure at home when I'm stressed and it really doesn't seem to rise much, though. I plan to talk to my doctor at my upcoming check up and see what he thinks I should do. I just don't want to get knocked out of the hiring process for being on HBP meds. Of course my own health has to take priority so if my doctor recommends it, I'll do what he says regardless.

[johnsonizzle]

Have you discussed possible underlying causes of the hypertension? Too much stress? Too much sodium intake? Etc... Might be easier to correct the underlying cause if you havent tried that yet.

[gaFIRE1]

Yes, caffeine is a major trigger for me. I can't go anywhere near it. Sodium can raise it as well. That can be more difficult because I can't always know what people or restaurants have put in their food. I also have to get a really good cardio workout pretty much every day. Especially if I drink caffeine or miss my cardio, it can rise above normal limits.

[FDNY-USCG]

I have a quick question in regards to this problem. Whats the max your blood pressure can be at?

[gaFIRE1]

I can max out at about 150/99 if I know it matters.

[FDNY-USCG]

So if i understand this correctly, the max blood pressure varies between different candidates? So im assuming they take height and weight into consideration to figure out your max? correct if im wrong please. Im trying to get myself prepared for the FDNY.

[powerhourcoug]

Are you in good shape? What is your BMI?

[gaFIRE1]

Where I tested, they wouldn't allow me to take the physical agility if I wasn't under 140 or 150 over I think 95. I may be off a bit on those numbers. It's been a while. I just know that I barely slid through. Height and weight didn't matter. The BP just had to be within normal limits. They don't want anybody to go out there and have a heart attack. I don't blame them.

[gaFIRE1]

I'm in pretty good shape. My BMI is 23...not considered overweight. I'm a female and my body fat percentage is in the 20's.

[FDNY-USCG]

Ok thanks Gagirl. That was useful information. My BMI is around 18. Im in pretty good shape. Depends on the situation but mine sometimes rises borderline hypertension.

[johnsonizzle]

Something to keep in mind is that the CPAT is not very hard at all compared to most departments actual academy. The CPAT is 10:20. Most academies do a minimum of an hour of PT each morning. If you were barely allowed to take the CPAT, I would take the time to review the NFPA medical requirements to see if you will pass the final medical exam if you make it to the end of the process. It would really suck to make it all the way to the end, get a conditional offer, then fail the medical.

[gaFIRE1]

Something to keep in mind is that the CPAT is not very hard at all compared to most departments actual academy. The CPAT is 10:20. Most academies do a minimum of an hour of PT each morning. If you were barely allowed to take the CPAT, I would take the time to review the NFPA medical requirements to see if you will pass the final medical exam if you make it to the end of the process. It would really suck to make it all the way to the end, get a conditional offer, then fail the medical.

Funny thing is, after the test, they retook it and I was very well within normal limits. I got my cardio for the day and that lowered it. I am leaning towards getting the meds the more I think about it, though. I just can't take the chance of not even being able to test and the reality for me is that if I do get hired, I'll probably have to take the medication anyways just because I may not always get 6 days of cardio. I just hope that they don't consider me risky because I have to take meds.

[rams32]

I was just hired at a full time department. I have moderately high BP. It fluctuates anywhere between 125-140 systolic. I almost didn't get signed off to enter my FFI academy because my BP was around 140 at the physical(Doctor let me rest for 10-15 mintues and the next reading was 135 so he signed me off). I didn't realize caffiene had such an effect. Prior to my medical for the job i just got I cut down the caffeine and didn't have any on the day of the test. I tried to relax during the exam and my BP was 124/80.

It is crazy to potentially approve/deny you a job based on one reading but I guess that is the way some places do it.

[gaFIRE1]

I was just hired at a full time department. I have moderately high BP. It fluctuates anywhere between 125-140 systolic. I almost didn't get signed off to enter my FFI academy because my BP was around 140 at the physical(Doctor let me rest for 10-15 mintues and the next reading was 135 so he signed me off). I didn't realize caffiene had such an effect. Prior to my medical for the job i just got I cut down the caffeine and didn't have any on the day of the test. I tried to relax during the exam and my BP was 124/80.

It is crazy to potentially approve/deny you a job based on one reading but I guess that is the way some places do it.

I'm glad you got through! Do you if they would have rejected you if you had been on meds for it? I think that as long as they give me the time to relax that I could get it under 140 but it would really stink to get that far and get rejected due to it being high!

[jtucker1384]

(1)*Hypertension with evidence of end orga n damage or not controlled by
approved medications

A.6.9.2.1(1) Hypertension that is uncontrolled, poorly controlled, or requires medication
likely to interfere with the performance of duties. Hypertension is an illness that can lead
to functional impairment and potential for sudden incapacitation.
______________________________ ______________________________ _______________
Category B Medical Conditions: A medical condition that, based on its severity or degree, may preclude a person from performing as a fire fighter in a training or emergency operational environment by presenting a significant risk to the safety and health of the person or others. A candidate shall not be certified as a meeting the medical requirements of this standard if the physician determines that the candidate has a Category B medical condition specified herein that is of sufficient severity to prevent the candidate from performing, with or without reasonable accommodation, the essential functions of a fire fighter without posing a significant risk to the safety and health of the candidate or others.

4.4.7 Heart and Vascular System.



4.4.7.1 Heart.

Category A medical conditions shall include:

a) Current angina pectoris.

b) Left bundle branch block or second degree Type II atrioventricular block.

c) Myocardial insufficiency.

d) Acute pericarditis, endocarditis, or myocarditis, Chronic pericarditis, endocarditis with resultant significant valvular lesions, or myocarditis leading to myocardial insufficiency or excludable arrhythmias.

e) History of myocardial infarction, coronary artery bypass, or coronary angioplasty.

f) Cardiac pacemaker.

g) Recurrent syncope.



Category B medical conditions shall include:

a) Significant valvular lesions of the heart including prosthetic valves.

b) Coronary artery disease.

c) Atrial tachycardia, flutter, or fibrillation.

d) Third degree atrioventricular block.

e) Ventricular tachycardia.

f) Hypertrophy of the heart.

g) Recurrent paroxysmal tachycardia.

h) History of a congenital abnormality.

I) Any other cardiac condition that results in a person not being able to perform as a fire fighter.
______________________________ ______________________________ ______________
(5) Category A and Category B Medical Conditions:
• (a) A Category A Medical Condition is a medical condition that would preclude an individual from performing the essential job functions of a municipal fire fighter in a training or emergency operational environment, or present a significant risk to the safety and health of that individual or others.
• (b) A Category B Medical Condition is a medical condition that, based on its severity or degree, may or may not preclude an individual from performing the essential job functions of a municipal fire fighter in a training or emergency operational environment, or present a significant risk to the safety and health of that individual or others.


2. Vascular System
• a. Category A medical conditions shall include:
o i. congenital or acquired lesions of the aorta and major vessels,
o ii. marked circulatory instability as indicated by orthostatic hypotension, persistent tachycardia, and severe peripheral vasomotor disturbances,
o iii. aneurysm of a major vessel, congenital or acquired,
o iv. untreated persistent hypertension (systolic blood pressure of 160 mmHg or greater or diastolic blood pressure of 100 mmHg or greater).
• b. Category B medical conditions shall include:
o i. persistent hypertension controlled through medication (systolic blood pressure less than 160 mmHg and diastolic blood pressure less than 100 mmHg),
o ii. peripheral vascular disease, including intermittent claudication and Raynaud's phenomenon,
o iii. thrombophlebitis,
o iv. chronic lymphedema,
o v. severe varicose veins,
o vi. any other vascular condition that results in an individual not being able to perform as a fire fighter





This was from a few different sources so take it as you want.

[gaFIRE1]

That helps quite a bit. Thanks!

[firehousefreakshow]

I had High blood pressure anywhere from 140 to 160 over 70 to 90's. I got on a high blood pressure medication and it's completely corrected. 120's over 70 consistantly. I am a fulltime FF. It's kind of like having corrective lenses in a sense that its easily correctable and no it will not prevent you from getting the job. It's really not a big deal. There are tons of people out there with high blood pressure. I have 3 friends on full time departments that have high blood pressure and they are on meds. It will not disqualify you. Talk to your dr and get Licinopril. Not sure on spelling. There aren't any side affects.

[rams32]

I'm glad you got through! Do you if they would have rejected you if you had been on meds for it? I think that as long as they give me the time to relax that I could get it under 140 but it would really stink to get that far and get rejected due to it being high!

I actually didn't read the medical standards until after my exam. I don't think meds would have disqualified me. But I sure wasn't going to go on them until after I was hired just in case . I found out the disqualification BP was 160 or over so I was a long ways from that. 140 - 160 without any other significant medical conditions is at the MD's discretion.