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”.
Please read through some of the questions and answers posted below. This will help everyone to not have duplicate questions. Thank you!
If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.
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Hi Doc,
On Friday my BP for a required physical by my employer was 186/94… then 10 minutes later it was 156/94. I was forced to do this with a year left on my current physical because I had a high spike in my BP prior to it. I’m on meds and the doctors through testing determined my hypertension is weight based. Everything looked good per the doctors yet the new physician who did my DOT only gave me a 3 month certificatcation. Am I correct in believing I should have received a 1 year and not a 3 month? What are the newest guidelines per FMCSA regarding hypertension and what we’re allowed on time on our medical cards?
Thank You
Ken H
@ Kenneth H
The CME is correct, your blood pressure is not completely under control. They issued you a 3 month card to give you time to get your BP below 140/90. That’s a long standing FMCSA guideline.
Hi Doc-
Getting on a bus tomorrow to go to a CDL school, and am worried about the blood pressure reading.
When Im being “good”, my blood pressure is pretty normal on medication. I take Indipamide 1.25mg and Almdipimine 10MG. My concern is that the Amlidipine will disqualify me to to the side effects of “dizziness, use caution when operating a motor vehicle” even though I have never experienced any of these side effects. Do I have a reason to be concerned?
Thanks so much.
@ Mary
With proper documentation and a medical release form from your doctor indicating the length of time on your present medication regime, you may be OK’ed for a one year certificate.
Can I still driver wow being on dialysis
@ Colby G
Not as a class A driver.
What about a school bus driver being on dialysis?
@ Mike
This will be a state related question and will be best answered by your local drivers license department.
Can I get back the 2 year certification again if my BP is normal from the Stage I hypertension without taking medication?
@ Eric
FMCSA reads it like this: is or has there been a history of high blood pressure. With your doctor’s note of compliance and a healthy life style, it may be possible. But give it some time.
I went to renew my dot fed med card 2.5 months ago. I get a little nervous when i’m there which causes my blood pressure to go up. I was given a 3 month temp card and a form for my doctor to fill out to evaluate my bp. I went back to the dot place for a follow up on my bp. the lady at the counter said the I had to do my physical all over again. she stated that was the new dot rule any body that gets a 3 month card has to do another physical again. Is this true or is she just confused about the rules.
@ Mark
FMCSA has requested and required that a new physical be performed to make a valid determination regarding the drivers fitness for duty.
If I fail a second D.O.T medical exam for HBP what happens to my Class A license
@ Brian V
Most states require a valid medical card to maintain a valid class A license. But you should have enough time to get with your doctor and get your BP under control.
I just started hemodialysis. MY dot certificate expires in November. Does being on dialysis disqualify me for getting my certificate renewed?
@ Brooke
Your DOT medical card became in-valid the moment you started hemodialysis. Once you are released to return to full normal work duty you will need a new DOT medical certificate. Make sure you bring a medical release form from your doctor and your latest test results.
I took my dot physical and was told i have high blood pressure. Was given a one year card. But felt they got me nervous asking all these questions. I went to my doctor and he said my blood presure was normal. Will i always have a one year cert. From now on
I have anxiety and have had for the last two years. I have been getting my DOT physical at the same location for two years. I went to get my recent DOT physical and the doctor said they needed a letter from my primary care doctor stating that I’m compliant with treatment and not abusing medicine. Is this something that sounds to be correct?
@ Patricia A
It is correct, the examiner is requesting additional information to aid in his decision making process.