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You are here: Home / Ask Trucker Docs / Blood Pressure Tips during the DOT Physical Exam

Blood Pressure Tips during the DOT Physical Exam

April 20, 2015 By Trucker Docs™ 85 Comments

A professional driver asks Trucker Docs™…

I usually get high BP only when this DOT physical is due!! What can I do? “

Here are some tips to manage your blood pressure and have it measure as low as possible during the exam.

Each of these factors may affect your blood pressure reading a number of points:

  • Nicotine/Caffeine.  Nicotine and caffeine both raise your blood pressure temporarily. It’s best to refrain from smoking, chew, coffee, tea, sodas, and energy drinks a few hours before the examination. Replace caffeinated drinks with water to stay hydrated.
  • Tired.  Tired, weary, stressed? Your blood pressure is likely to go up. Get rested before the examination and leave plenty of time to get to your appointment. Get to your appointment early so you have time to sit and relax.
  • Temperature.  Blood pressure tends to increase when you are cold. If you’re at the doctor’s office and the room temperature is “chilly” to you, be aware that your blood pressure readings may be higher than expected. Dress to stay warm.
  • Glass of water.  Drink a full glass of water before you get to your appointment. This will help calm your body as well as prepare you to give a urine sample.
  • Full Bladder.  Your blood pressure is lower when your bladder is empty. Ask the doctor to perform the urine test prior to the physical exam.
  • Emotional State.  Stress or anxiety can cause large increases in blood pressure. If you are thinking about something that causes you to tense up or become stressed whilst having your blood pressure taken, the levels could significantly increase. While your blood pressure is being taken, be quiet and think about something far away that makes you feel happy and relaxed.
  • Talking.  If you are talking to the examiner while having your blood pressure taken, studies have shown that your systolic blood pressure measurement may increase 10 to 15mmHg. Be comfortable talking beforehand, especially if you’re chatting about something that makes you feel happy or relaxed, like a sport or hobby, or a vacation. Then be quiet during the blood pressure reading.
  • Restricted Breathing.  Holding your breath because you are nervous will raise your blood pressure. Breathe slowly and deeply like the doctor tells you to when listening to your heart with a stethoscope. Breathing slowly and evenly will help your body to relax.
  • Arm/Back/Feet Unsupported.  When having your blood pressure measured, you should always be seated in a comfortable chair, legs uncrossed, with your back and arm supported. If your back is not supported, your diastolic blood pressure measurement may be increased by 6 mmHg. Crossing your legs has shown to raise your systolic blood pressure by 2 to 8 mmHg. The positioning of your upper arm below your heart level will also result in higher measurements, whereas positioning your upper arm above your heart level will give you lower measurements. These differences can increase/decrease your systolic blood pressure 2mmHg for every inch above/below your heart level.
  • Blood Pressure Cuff Used Over Clothing.  Studies have shown that clothing can impact a systolic blood pressure from 10 to 50 mmHg. When having your blood pressure measured, the cuff should always be placed directly on your arm.

Bonus tip:

  • Get Your Spine Aligned!  Pain or physical discomfort tends to raise blood pressure. Several studies have shown that chiropractic adjustment will lower blood pressure after the correction is delivered.
Thanks to Trucker Docs™ expert panel doctor Michael Impaglia, DC for contributing this article. You can get your DOT physical with Dr. Michael Impaglia in Buffalo, Depew, NY.

 

DOTDoc-nutshellPut In A Nutshell

The doctor is on your side so let him/her take care of the examination!
The best thing you can do is go to a happy place far away and breathe slowly, and deeply, and evenly, in and out. It does help.

 

Filed Under: Ask Trucker Docs, Medical Conditions

About Trucker Docs™

TRUCKER DOCS™ is a dynamic panel of DOT Certified Doctors helping Commercial Drivers through the DOT Physical jungle.
 
 
We are DOT certified medical examiners, and we're around to answer questions - especially those tough ones related to a driver's personal circumstances - that no-one else is answering.

Please leave a QUESTION or COMMENT below.

Comments

  1. Donald says

    July 27, 2020 at 12:44 pm

    Can you still drive a truck if the physical is not complete do to waiting to get a compliance report on the CPAP device!?

    Reply
    • Trucker Docs™ says

      August 2, 2020 at 12:48 pm

      @ Donald
      Do you have a valid medical card? If not, then the answer is no. If the CME registered your card as pending, then your old card has been suspended and waiting for further information. If the CME has not registered your new medical card, then you are still operating on the old card. You will need to check with your examiner on this issue.

      Reply
    • Charles says

      May 8, 2021 at 9:18 am

      When I had mine, they gave me a temporary 3 month passed physical while I attempted to get my compliance report in order. This may not be valid in all States.

      Reply
  2. Eric says

    April 6, 2020 at 11:12 pm

    So with all the covid-19 going on right now. All the dmv locations are closed in my state of Illinois. I got a letter in the mail Saturday saying they was suspending my cdl due to not submitting my medical card. But I DO CURRENTLY HAVE A VALID one. I just cant get to a facility to have it submitted. The secretary of state police told me today that I am basically up a creek until the facilities open. Is this true, Their has to be something I can do to get this submitted instead of sitting at home not making any money until they open back up on May the 1st if we are lucky. All suggestions or advise would be greatly appreciated at this point!!

    Reply
    • Trucker Docs™ says

      April 10, 2020 at 5:09 pm

      @ Eric
      Check online to see if there is more than one way to get the information to the state. And the DOT?FMCSA has granted an extension, so check with your state DLD to confirm the length of the extension in your state.

      Reply
  3. Melinda says

    February 7, 2020 at 12:39 am

    My step dad in Chicago just took his 2 year exam at a DOT office ( one of many in the city) paid $178 out of pocket. His card was already one day expired. He has no known health issues. He said this location was so unprofessional it frustrated him. His hearing test was the training nurse being told to blow and whisper in his ear with a piece of paper covering his ear. They took his weigh 3 times and by the time they took his BP he was sweating and pissed. His BP was 150/90. He explained he don’t hv High BP. He was then told because of his neck size and waste measurements with the BP test he is required to take a sleep apnea test. He was given a card for only 3 months. He told the dr he don’t see a need for a sleep apne bc he don’t have problems sleeping, he doesn’t snore and he can’t afford a sleep study. His exam was a sham. My question is do he have to follow up with me this doctor in 3 months or can he go to another Certified doctor for a legit exam?

    Reply
    • Trucker Docs™ says

      February 9, 2020 at 10:10 am

      @ Melinda
      Use the 3 month card for a couple months and then go elsewhere for another examination/second opinion.

      Reply
  4. David says

    March 5, 2019 at 3:31 am

    Just went to do my 2yr DOT physical recertification and the CME said I could only renew for 1 yr due to taking Seroquel and trazadone which I’ve been taking for over 5 years. I also take Gabapentin. Had to get the extra documentation needed to pass. But now I only get it for 1yr and not 2 yrs as I have always gotten in the past. Confused…has DOT changed there term rule or did the CME make a mistake?

    Reply
    • Trucker Docs™ says

      March 18, 2019 at 9:31 pm

      @ David
      The DOT/FMCSA is getting more strict and the examiners are at greater risk if something goes wrong. Examiners have the right to limit the length of a card due to any medical condition. Your examiner wants to keep a closer eye on your situation, we guess. No mistakes, just their judgement call.

      Reply
    • Clint says

      September 1, 2019 at 11:39 am

      Can CDL drivers use OTC lidocaine patches?

      Reply
      • Trucker Docs™ says

        September 3, 2019 at 7:05 pm

        @ Clint
        Is should raise questions by the CME. He may request further information. If the patches are not interfering with your ability to perform your job discerption, then there should be no issues.

        Reply
  5. Lee says

    July 24, 2018 at 9:05 am

    Hello, I want to start my trucking carrier and want to look into some companies to gt my CDL, My question is I had a heart attack back in January, would this prevent me from passing a DOT exam? or would I need something from my cardiologist to clear me?

    Thank you!!

    Reply
    • Trucker Docs™ says

      July 29, 2018 at 9:06 pm

      @ Lee
      You will need documentation from your cardiologist. Medical release forms and a working prognosis with recent test results.

      Reply
  6. Jose M Jr. says

    May 7, 2018 at 7:35 am

    I had a class b license ..i had 2 dirty urine samples with 2 different companies within a couple of years apart….i didn’t think i wanted to drive anymore..i recently let the license expire……can i try for a class a having second thoughts

    Reply
    • Mario A G says

      June 26, 2018 at 10:58 pm

      You can but you have to answer questions regarding to past drug positive testing when applying to carriers

      Reply
    • Cheez says

      May 10, 2019 at 11:59 pm

      If its something you really want to do then go for it no matter yiur pass. Pray on it. My DAC is so jacked up but i work for a great company and started taking trucking more serious and a opportunity presented itself and I haven’t took it for granted yet good luck

      Reply
  7. Jennifer B says

    April 24, 2018 at 2:02 pm

    I’ve been a driver for 25 yrs. In recent years, my issue has been passing with my BP. Again, hopeful that I’ll pass that, I wonder if I must divulge recently having been diagnosed with possibly Fibromyalgia? If not, must I divulge that I take a muscle relaxer, if I only take it when I’m not driving commercially?

    Reply
    • Trucker Docs™ says

      April 29, 2018 at 10:52 am

      @ Jennifer B
      The fibromyalgia may not be a big issue, but the pain medications will be. Get a medical release form from your prescribing doctor explaining your situation. The CME needs to have all the available information to make a final determination. Leaving out pertinent information puts you and the CME at risk of losing your licenses.

      Reply
  8. randy s says

    April 2, 2018 at 7:53 pm

    I had tia mild stroke January 29,2018 treated and held overnight for observation neurologist cleared me to go back to work with no restrictions, but when I went to renew my health card dr. said no driving for one year. I have class a cdl. what is up?

    Reply
    • Trucker Docs™ says

      April 8, 2018 at 3:23 pm

      @ Randy S
      FMCSA is strict on this due to re-occurance of another stroke. You may want to check into intra-state only driving during your wait period. Check with your local drivers license department to confirm.

      Reply
  9. JB W says

    March 10, 2018 at 7:43 pm

    I live in Texas and my dot medical card expire on 03/19/2017 but i do not get paid until the 21st. can they give me a grace period for a few day, or what is the penalty if i wait those 2 days?

    Reply
    • Trucker Docs™ says

      March 25, 2018 at 7:49 pm

      @ JB W
      Check with your states drivers license department for the best answer.

      Reply
      • Gerald says

        September 9, 2019 at 3:05 am

        Per Federal Law, you may not drive a commercial vehicle while your card has expired. You can operate non commercial vehicles. Usually, companies will accommodate situations as yours with non diving jobs or your approved leave

        Reply
  10. Robert G C says

    February 19, 2018 at 3:57 pm

    I had cardiac stents in march 2005.I don’t have any problems with them and even went to Iraq in 2007 until 2010.I had my re-certification recently and the dr said I need a stress test.I was given a 3 month medical card.My insurance won’t pay and the dr told me the cost is between $2000 and $3000.Is the stress test a new requirement?He said all my vital signs were normal.

    Reply
    • Trucker Docs™ says

      February 26, 2018 at 6:43 pm

      @ Robert G C
      Heart conditions that fall in certain categories would require a new stress test every two years. FMCSA passed those guidelines some years ago.

      Reply
  11. GPautz says

    November 29, 2017 at 2:36 pm

    my husband went to for his medical exam to renew his medical card. He did not pass the BP test….they waited a few minutes and retook it and it was 140/90…so he was happy…..but the doctor said it had to be constant so he did not pass him. Is that right?
    They gave him a prescription for BP and an extension on the card.
    They also went on and took a blood sample, which is not in the requirements, correct?

    Reply
    • Jason says

      June 18, 2019 at 10:16 pm

      I know this is old….. honestly he should have walked out… told him he was discontinuing the exam. Once you are on blood pressure medication, you can only get 1 year cards. He was exhibiting “white coat syndrome”….. a common thing where people are nervous, and their blood pressure is high. You are paying them for the exam….. They are working for you. Yes, they have to follow the regulations. Sounds like you went to a regular doctor…. who wanted to sell you on a prescription, and follow up. I had my exam done at a chiropractor. He was very thorough (any doctor has to go through medical school) but he was just doing his job with the DOT physical, no more, no less. The only “upsell” was he did recommend I see a regular doctor once a year.

      Reply
      • Antonio says

        July 7, 2019 at 5:17 pm

        So u can have chiropractic do exams for physical d.o.t

        Reply
        • Trucker Docs™ says

          July 14, 2019 at 8:13 pm

          @ Antonio
          If the Chiropractor is on the national registry, then yes he is qualified to perform the DOT medical certification examination.

          Reply
  12. Diane N. says

    September 26, 2017 at 1:48 pm

    I took my DOT physical yesterday, my heart rate was too high so they gave me a medical card good for 1 month. I have to go on blood pressure meds then within this month i have to go back to be rechecked. Do i wait until i get a new card before i take my CDL permit test, or can i take it now?

    Reply
    • Mario A G says

      June 26, 2018 at 11:16 pm

      You can but you have to answer questions regarding to past drug positive testing when applying to carriers

      Reply
    • Makenson says

      September 29, 2018 at 3:26 am

      I’m from Florida can I have have my medical card in Georgia or any other state

      Reply
      • Trucker Docs™ says

        October 2, 2018 at 7:54 pm

        @ Makenson
        Yes.

        Reply
  13. Richard L says

    August 28, 2017 at 12:24 pm

    I just took my DOT physical here in California. BP was 141/88 and I was failed. I also used my CPAP machine for 68% of the time according to the print out I used my CPAP machine for 68% of the time. 70% is required. So I failed that too. I was told there are no longer 90 day extensions on Cpap compliances so I can’t drive for 7 days and after 7 days must show that I used the machine more then 70% in those 7 days and then I can drive for 30 days and show the report again and if passed I get a 1 year authorization to drive. When did the NO 90 day license extension take effect,? Does it also apply to borderline high blood pressure?

    Reply
  14. Joe B says

    May 10, 2017 at 5:16 pm

    Is acceptable to lay down or recline for bp test during physical?

    Reply
  15. Glen says

    March 31, 2017 at 4:11 pm

    Do the medical examiners check your medical/prescription history on a database? or do they just go by written form filled out by driver?

    Reply
    • Trucker Docs™ says

      April 1, 2017 at 4:13 pm

      @Glen
      They can check the data base.

      Reply
  16. mike says

    February 7, 2017 at 7:44 am

    I was given a one year medical card due to alittle high blood pressure can I get a two year card next time if it is good.

    Reply
    • Trucker Docs™ says

      February 7, 2017 at 5:59 pm

      @Mike
      Possibly, if you are not taking any type of blood pressure medication or have not been on any medications before.
      The new FMCSA forms ask if you have ‘ever’ had, so if it was a one time high and no meds, then you could be OK.
      Best bet is to watch your lifestyle and see if you can get it down by yourself. Check your blood pressure every couple of weeks, and have a real doctor check it, not one of the free automatic ones.
      If everything is going fine then you should be good. If after a six month period your pressure is still a bit high, then check with your doctor about how to get it down further. If placed on meds, then the medical card will only be good for one year at the time. Good Luck

      Reply
  17. Allen says

    January 12, 2017 at 3:12 am

    Can a company require that you are only able to use a certain CME?

    Reply
    • Trucker Docs™ says

      January 13, 2017 at 6:31 pm

      @Allen
      All depends on the company policy. But in reality you have the right to go to any CME that is on the national registry.

      Reply
      • Don M says

        December 20, 2017 at 11:49 pm

        I would think that if the company is requiring and paying for the physical, then they probably are within their rights to select the place in which you will go. I have had this happen a few times and just followed the orders from the company as it was a pre-employment physical, and they were indeed picking up the tab.

        Reply
    • Jason says

      June 19, 2019 at 6:08 pm

      Here’s the thing….. if your company says you have to go to a certain examiner, then you do. If you think you will have an issue there, NOTHING says that you can’t pay for your own exam, and choose your own examiner. The cost is not all that much, I had it done for $70. Then you show up to your company doctor,,,, you get the exam….. doesn’t matter if they pass or fail, you already have your DOT card. If they fail you and your company won’t employ you, you have a CDL and a DOT card…… there are 500 companies hiring.

      Reply
      • Trucker Docs™ says

        June 23, 2019 at 7:49 pm

        @ Jason
        Be aware, if the last examiner fails the driver and reports it to the FMCSA registry, then the last card reported is the one on file.

        Reply
  18. Michael C says

    October 17, 2016 at 7:09 pm

    On November 3rd 2015 I had a high blood pressure reading during my DOT physical for the first time in thirty years. I was given a three month card and told to see my personal physician. He instructed me to monitor BP for two weeks. Upon completion and getting great results on a cholesterol test I was told I did not need blood pressure medicine. Two months later I went back for DOT physical and passed with a second reading of 138/88 but was only given a one year card. What do my readings have to be this time to pass? I still do not take blood pressure medicine and have readings at home between 120/80 to 145/95.I will be 53 Nov.23

    Reply
    • Trucker Docs™ says

      October 18, 2016 at 12:59 pm

      @Michael
      Blood pressure reading at the time of examination need to be 140/90 or less. If you are not taking any medications then you could qualify for a two year card. If there is a history of high blood pressure in the past, then the CME may hold you to a one year card. He really only wants to monitor your situation before signing off on a two year card. All of this is based on everything else being within normal limits.

      Reply
      • Steve says

        April 28, 2017 at 5:52 am

        I took my physical in February. They used a machine that kept repumping and gave a slightly eleven ed pressure. I requested a manual pressure test which produced a reading of 140/90. The doctor failed me and issued a 90 day certificate because she said it had to be less than 140/90! My physician has increased my med but I am panicking servery and I am afraid. What is next?

        Reply
        • Trucker Docs™ says

          May 1, 2017 at 11:09 am

          @Steve
          FMCSA guidelines require a 140/90 or better. As long as you are at those levels, you will be fine. You do want your pressures down below the guidelines recommended, and your card will be good for one year at the time. The three month card was for you to have your doctor reassess your meds and get your pressure below the cut-off.

          Reply
  19. Ann says

    September 28, 2016 at 10:38 am

    If your Medical card expired is there a grace period

    Reply
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