FAQ – Blood Pressure DOT Guidelines
What are the blood pressure requirements to pass the DOT physical?
Can I get a DOT medical card if I have hypertension?
Can I pass the DOT physical if I’m on blood pressure medication?
What if I don’t normally have high blood pressure, but I have “white coat syndrome”?
What are the blood pressure requirements to pass the DOT physical?
Here are the medical guidelines according to the Federal Motor Carrier Safety Regulations (FMCSRs). Note that employers are allowed to impose more stringent medical requirements.
Normal Range:
A driver with a BP of less than 140 / 90 may be medically certified to drive for a two-year period.
First time BP elevated:
Stage 1:
A driver with a BP of 140 – 159 systolic and /or a BP of 90-99 diastolic, has stage 1 hypertension, and may be medically certified to drive for a one-year period. Certification examinations should be done annually thereafter and should be at or less than 140/90.
Stage 2:
A driver with a BP of 160-179 systolic and/or a BP of 100-109 diastolic, has stage 2 hypertension, and is a candidate for antihypertensive drug therapy. The driver is given a one-time certification of three months to reduce his or her blood pressure to less than or equal to 140/90. Provided treatment is well tolerated and the driver then demonstrates a BP value of 140/90 or less, he or she may be re-certified for one year from the date of the initial exam. The driver is certified annually thereafter.
Stage 3:
A driver with a BP at or greater than 180 systolic and / or 110 diastolic has stage 3 hypertension and is disqualified. The driver may not be qualified, even temporarily, until blood pressure is reduced to equal to or less than 140/90 and treatment is well tolerated. The driver may then be certified for 6 months and biannually (every 6 months) thereafter, if at recheck BP is equal to or less than 140/90.
Other Medical Conditions:
Drivers with Type 1 or Type 2 diabetes, or kidney disease require treatment if their blood pressure rises above 130/80, since they already have a high risk of heart disease.
Can I get a DOT medical card if I have hypertension?
The DOT blood pressure limit for you to get a medical card depends on your level of hypertension. You can get a limited medical card for first-time stage 1 or 2 hypertension. The hypertension stages and limits are laid out in the Q&A above which describes the FMCSA blood pressure requirements to pass a DOT physical. The medical examiner may require clearance from your treating physician before you can be considered for certification.
Can I pass the DOT physical if I’m on blood pressure medication?
Taking blood pressure medication will reduce your DOT medical certificate to one year. Your blood pressure must be controlled and be below 140 / 90 at the time of your DOT examination.
Help the CME to certify you: Bring a note from your treating physician that states that your condition is being treated and that the treatment has been shown to be effective, safe and your condition is stable. This information helps the medical examiner back up a decision to pass you on the DOT physical.
What if I don’t normally have high blood pressure, but I have “white coat syndrome”?
First off, we understand that this is a very real concern for some drivers. If you have “white coat syndrome”, tell the CME. Ask to have multiple BP’s taken. The examiner should be taking 2-3 readings anyhow, especially if you say so up front.
Look for certified medical examiners on this website. Each DOT Physical Doctor in our trusted network has a page describing their office and services. Find one who you would feel comfortable with. This should help reduce your “white coat syndrome”.
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I have had my CDL for 3 years now. I have been issued a one year certification due to my blood pressure being controlled by medications. However, my last DOT exam I was issued a 2 year certification even when I disclosed my medication AND the fact that I have been issued a card for less than 2 years on the form. Will I run into a legal ramification with this or is it simply up to the discretion of the examining doctor?
@ Kimberly J K
Your examiner does not understand the FMCSA regulations and as you stated should have issued a one year card only. This was not your error. We recommend that you continue with the one year re-examination and make sure you find an examiner that understands the FMCSA guidelines.
Does having anxiety disqualify someone from driving a CMV?
@ Dawn
If you are taking med for the condition, then make sure you have a medical release form from your prescribing physician.
I suffer from chronic pain for which there is no viable cure or treatment other than medications that would prevent me from passing the drug screen testing. My PCP says although I am being treated for high blood pressure he believes that 90% of my problem of the higher BP is due to the chronic pain and 10% to being overweight. He’s found no evidence of heart disease. I’m already on a one year schedule for physicals. My PCP is not DOT certified. How do I continue to qualify?
@ Terry A
You should continue with the process that you have been using. Apparently you have continued to qualify for a one year card, so keep doing what you have been doing.
For the past three one year certificates I have submitted a letter from ENT for CPAP compliance and another letter from my Internal Medicine Doctor certifying “no diagnosis of hypertension” with weeks worth of BP readings averaging 130/70. I have “white coat” and always read high like 150 to 175 for Systolic. Diastolic always lower than 80. I have still been given a one year. This time I got a 3 month even with the repeated proof and documentation. I don’t trust anyone any more. Thought Medical Registry imposed some level of standardization but different facilities still apply disparate standards in dealing with special situations.
I am a combat veteran and when I don’t trust people or the system my anxiety and stress rockets up. My job is on the at every exam. Never know what to expect…..
did you notice you never get an ansaw when your bp goes up and down for mood change because this whole physical is a scam. i want to know how many drivers had accidents back before you was required to take a physical what about driving cars you have more cars on the road then trucks why take a mans lively hood away because of high bp do we live in a free country or not try makeing people who drive cars have to take physicals i dont think that would work out for them to well. i used to be very athletic in my younger years I ran 5 miles a day my bp went up and down 130/90- 140/80 some times 145/90 I am now 60yrs old and my bp is still the same depending on my mood so depending on my mood i should loose my cdl and starve my family because of my mood that day its ridiculous i watched a man loose his work and was scared to death he was not going to pay his bills he cried like a baby he didnt know how to explain to his wife they may be evicted if he cant get his med card soon I payed his rent for him until he got it its so hard to watch this beautiful country go down this way but if the country had an emergency they would suspend that rule in a minute the hypocrites
I have never taken medications for HBP. I went and got a 90 day because my BP was high. I am seeing my DR to try and get it under control. What happens if I can not get it under control with in the 90 day window? It has me very concerned because I can not afford to lose my job. Can I get another extension while I work on it with my doctor, if I show I am working on getting it regulated? Thanks
@Chriss
It may be possible, but don’t count on it. Most cases the CME wants to see it under control before giving you a new medical card.
Sorry. Could not find a good place to stic” this question in here. I was put on bp meds a few years back and given the 1 year cert. I have not taken any meds for bp or anyother now in two years, i have my diet and bp all under control, yet the concentra nurse tells me its virtuallt impossible to go back to a 2 year cert and will not tell me the process to doing so. Of course they want that annual dollar for my physical but i want my 2 year cert back. How do i go about doing that. Our company only uses a certain facility so my options are null so far as going to a different examiner.
4got to give u my numbers. Just got through with a long walk and doing excersises. tested half hour and my bp was 110/73 pulse 71 on right arm and 111/73 pulse 71 on left arm. so my bp is well under control.
@ William
Sorry to say but the nurse is pretty much correct. FMCSA has set a guideline that indicates once on bp meds monitor yearly.
Blood pressure is a scam, the numbers are created AND lowered by big pharma companies because it’s a huge money maker. I’ve had the same BP my whole life, it’s always 140-150 over 85-95, I run and eat healthy, I’m not over weight at all. I don’t drink or smoke. I was put on Lisinipril because of the ridiculous DOT requirement, and it didn’t even make a difference, just made me really tired. Some people just have higher BP than others, the whole “silent killer” is a bunch of bull. My friend eats fast food everyday, never works out and has a gut from drinking beer every night, his BP is 120/70, so it’s all bullshit
You are absolutely correct!
You are correct. There is plenty of disagreement in the medical “profession” about that, so just because the ones who claim BP (taken in a stressful situation like a job-threatening hostile exam) has to be exactly under 140-90 for everyone then we are forced to “submit.” This FMCSA system is unethical. If they have a question about your BP they should then direct you to get an opinion from a real doctor and have that determine whether you pass or not.
I been on HP meds for three yrs and been getting a 1yr card when I went to get my physical done it was 133/90 and the doc side I was good for 2 yrs and I said I was on HPMeds and he said it under control and good for a 2 yr card is this right or should I have gotten a 1 yr card
@ Doug
FMCSA guidelines recommend a one year card for individuals on high blood pressure medications. You should have received a one year card.
Had much the same here. However I have been off my bp medication 5 months
I went back to receiving a 2 year card.
The Dr said since i was off the med , and stable i could go back to a 2yr card. Is this correct
@ Robert
It is up to the CME’s discretion, but in most cases you would need a medical release form from your primary doctor stating that he removed you from the prescription and the CME may hold you to a one year card to continue monitoring your bp. FMCSA writes it vaguely as “ever been on bp meds”.
I think the medical card is a scam. Trying to push Bp med just fmcsa has a low stand guidelines.
If I had a 3 month certification because of blood pressure but thought it was 6 months so haven’t seen physician yet and went back to get tested and haven’t improved/got worse would I get disqualified? Even if I’m scheduled to see my physician in the next upcoming days because of the misunderstanding
@ JJ
Your medical card became invalid three months ago. You only get one 90 day card and then, if no improvement, you are disqualified until bp is in the correct range.
just went and took DOT physical. The nurse went and took my BP over top of my hooded sweatshirt and said it was 152/90. Was sat in a room for 5 mins DR walked in and I explained how she took my BP and he re-took BP with cuff on my skin like your supposed to and got a 136/86. Why did he only give me a 6 month card????!!!!!
I received a 30 day temporary DOT medical card can I go and try to get recertified somewhere else this was due to a blood pressure reading that was too high or do I have to go back to the same ?
@Dave
You can goes else where for a second opinion. Multiple blood pressure readings should be taken during the DOT examination, if there is any questions. But you need to have your blood pressure under control, it is one of the silent killers.
Once they’ve threatened your retirement, livelihood and ability to survive and have a home (basically equivalent to waving a loaded gun in your face) by telling you the BP is 140/90, how do you think that affects the subsequent BP tests? This “physical” is a travesty and someone needs to protect innocent people from this abuse of power.
Someone needs to force the FMCSA to permit us to submit proof of low blood pressure from a reputable medical professional. It is immoral to have someone’s life depending on one or two or even three BP measurements during an exam in a hostile environment. And, furthermore, it is KNOWN by the medical profession that the diastolic reading is often inaccurate. If they’re going to use their measurements over those done over time by other practitioners, then they should be forced to prove the accuracy of the instruments they use and it should be done with a digital bp monitor where human error or deliberate malice cannot determine the outcome!
You should be aware that electronic blood pressure monitors are commonly 10% or more inaccurate in their readings. This is why EMT’s and Paramedics are taught to never use them.
I am a retired truck driver and I had nothing but trouble with my BP I was on BP meds. I hated every dot phy I took for my last 20 years of driving. So after I retired and got out of the truck. I lost 35 lbs it took a year. Before my wait lost my BP was 165/95 without meds now after weight loss my BP is 125/ 80 and no meds and I am 70 years old. So drivers lose weight and I know it’s hard with working the hours you guy do.