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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My coworker in tetirement company have. highBP he is not driving minibus saying that his dot card is expired..is it ok him to drive our companys other vehicles like continental .hightop our residents in it
@ Tarja N
Most states require a valid medical card to operate a vehicle that is used by a company that provides commerce/makes money. Best check with your state drivers license department for final determination and answer to your question.
I was wondering if I had a two year certification and 9 months later had to be put on blood pressure medicine do I need to do a recertification? An shouldn’t a note from my primary doctor to my job be accepted to drive?
@ Craig
You need to redo your medical certification examination. Try to have at least thirty days of medication use before going for the new medical card.
Also get a medical release form from your prescribing doctor.
So if your bp reading is over 140/90 you can still be giving a three month medical card?
@ Robert
Only one time to get your bp down below 140/90. And everything else has to be within normal limits. After that you will not receive a medical card until readings are below 140/90.
The nurse that gave my blood pressure test for dot physical today first tested my right arm. Arm was unsupported sitting with feet hanging sitting on bed. This is not the proper way. That test showed it was way over the 2 year limit. I asked to retest and support my arm. Still feet hanging. This barely was low enough for 2 year. Nurse was shocked it was so much lower. Why do most nurses not seem to know the proper procedure? What can be done about this? This is our livelihood after all.
I don’t yet have a CDL went to the DOT doc and had high blood pressure and got a 3 month certificate. What happens if it is still high when I am tested again? When would I be able to take another physical?
@ Reggie
If bp is high next time, you will not receive a medical card until your pressure is below 140/90. You can retake a DOT physical at any time you want within the 90 day period of your present medical card. Also, any time you fill your bp is within normal limits, you can retest.
(Calif) Last year I had a stint put in, this year when I went for my DOTPhysical I was told I had to get a Echocardiogram, is this a new rule?? & why do I need one, my heart is in great shape
@ Richard W
Welcome to DOT / FMCSA guidelines. Not new, FMCSA required every two years.
My Bp is a 1 yr tho I’m always 1 number to high on the bottom diastolic side and just can’t seem to bring it down anymore……not on meds or anything…..that 1 number will keep me from driving won’t it….I feel I know the answer but 1 number over there limit with no change after 8+ checks in 3 days would seem a bit drastic to keep someone from being behind the wheel but then again the next person may be 2 or even 3 from range n if they accepted myself n not the next person could open a can of worms……hence why they have guidelines ……if I could get the bottom number down even 1 number still searching
@ Maurice
It’s not just one number but a high bp reading over-all. Slowly work at getting your numbers closer to 120/80.
I have a one year dot certification with high blood pressure. If my blood pressure goes over 180/90 can I still legally drive a company issued/owned vehicle? I am asking because a co-worker had 190/123 bp and was still told to go on a service call. We work on diesel trucks
@ Holly R W
If the bp was taken by a CME, then no. This co-worker needs to have his blood pressure issue investigated further. He has an issue that could be deadly, both for himself and the public at large.
One of my drivers BP tested high so they issued a 3 mo card but told him if he came back prior to the expiration and after getting on meds and tested within acceptable range, they could re-issue the card for 1 year without doing another DOT exam. He did just that and they gave him a new card but my occupation health agent is telling me he has to have another complete exam…is this true?
@ Kim H
FMCSA requires a new examination each time.