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 Â may be medically certified to drive for a two-year period.
First time BP elevated:
Stage 1:
A driver with a BP of 140 â 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. Â 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 BPâs 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. Â 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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I was recently diagnosed with non cirrhotic portal hypertension. I’m being treated for it. My blood pressure has always and still is 120/60. I do have a class A license. Will I have issues renewing my fedmed card?
@ Brian
Your situation will raise questions with the CME. He/She will want supporting medical documentation from your healthcare providers. They will also request a medical release form from your doctors.
165 /80. i am coming up to renew my 1year which then was 146/90. am i disqualified now? my weight was 246.6 and now i am at 201 at 6 ft. my pulse was 101and it is between 80 and 90 consistently now. i changed diet watch salt and am moderately active.
@ Brett W
DOT/FMCSA wants a 140 / 90 or less on your bp. If you are on bp medications, then you won’t qualify. If you are not on medication, then you may get a one time three month card to get your bp below 140/90. And good job on getting yourself back in shape.
If I got 3 month card but go somewhere else and get card will that work
@ Michael S
Depends on why you were given a three month card.
Can I be on more than one HBP medicine and still pass a DOT physical in Washington State
@ Ken
Your list of medications will be questioned, but with proper medical documentation you could be fine. Be prepared to answer questions about your condition and your meds.
Hi I was given a 3 month medical card due to hbp. I have since gone to my primary care doc and he has put me on hbp medication which has reduced my bp below the levels required. I am going to get the medical release opinion form filled out before I go back to get recertified. Do I have to have the complete physical done again since I just did the last one less than 3 months ago? Hbp was the only problem. I live in Ohio. Can’t find that answer anywhere. Thanks
@ Rich F
You will have to do a complete DOT/FMCSA medical certification examination. It’s a FMCSA requirement.
I am a little confused. I am a CME. I follow the recommendation of the 2002 cardiovascular conference report recommendation tables, page 55 for Hypertension. For high BP in ranges of BP greater than 140/90 but less than 180/100, it notes that at certification I can give a 1 time certification for 3 months, and if at recheck BP <= 140/90 can certify for 1 year from date of initial exam. Is this wrong, out of date? I do not find any new/different DOT/FMCSA recommendations.
Thanks!
@ Ron
To the best of our knowledge there have been no major updates. There was a draft issued in 2020, which can be found on the web. It is only a draft. DRAFT FMCSA Medical Examiner Handbook-4-23-2020.pdf.
I just had dot physical on blood pressure medication on 11/17/2021 doctor gave me 2yr card my reading 130/74MY COMPANY SAID THERES Discrepancy doctor told me new regulations in June 2021 if blood pressure under control you can have 2yr card who’s right
@ R m
One year for any drivers on bp medication. Your blood pressure must be under control, but with meds, only one year at the time.
This matches what the practitioner told me when I went in. I received a 3 month, and was told to come back at that time and they would retest the blood pressure and if I passed, would be given a 1 year from the date of the initial exam (ie another 9 months).
@ Dina
That is correct.
I am trying to find the actual rule in the FMC regs where it says that a Doctor can give me a 3 month DOT ticket to get my BP under control…I just can’t find it, I have searched and searched, can you direct me directly to the rule so I can bring it with me to the Dr?
When I mentioned it to the girls that told me I had high BP, they were not aware of the rule and were telling me that they can only give me two weeks then fail me.
@ Bob J
# month card is a guideline not a regulation. When you determine certification for the driver with high BP in the ranges of stage 1 or stage 2 hypertension (BP greater than 140/90 but less than 180/100), consider these additional factors:
⢠Type of examination (certification or recertification).
⢠Current certification interval (1-2 years or 3 months).
⢠Treatment (lifestyle changes, use of medication).
⢠Severity of hypertension prior to treatment (particularly if history of stage 3 hypertension).
The purpose of the one-time, 3-month certificate is to allow the driver with high BP that is an absolute indication for antihypertensive drug therapy to continue to drive while taking steps to lower the elevated BP. It is not intended as a means to indefinitely extend driving privileges for a driver with a condition that is associated with long-term risks.
For the driver with high BP or hypertension to maintain continuous certification, the driver must demonstrate at examination BP at or less than 140/90.
NOTE: “One-time” means you cannot issue consecutive 3-month certificates for BP greater than 140/90. It does not mean once in a lifetime.
Thank you for the clarification.
@ Bob J
Glad to help, thank you.
I have been having blood pressure issues and canât get it down below regulation. I am on a 150 mg of bpm and it is still running like 170/110. Can the doctor pull my Healy card since itâs been over 3 months now. Or how long do I have to get it down. I have to renew in December
@ Jeremy
The CME can issue only one 3 month medical card for you to get your bp within regulations. After that you must have a bp reading below 140/90 or better. You will not have a valid medical card until it is within normal limits. So it appears that you have some time to get it under control.
Yesterday at dot physical my pulse was around 120 blood pressure was 140/76 was told I have 45 days to go back for re check of pulse to get it under 100 in the cdl guidelines where does it say the pulse need to be a certain number . Iâm going to my primary care Tomm for a check on it then have to bring results back to cdl doctor and make sure itâs under 120 my cdl expires December 31st is my cdl license still good for the 45 days she gave me to come back?
@ Stephen h
One, your cdl is state issued, so you would need to check with your state drivers license department to renew it. Two, a pulse rate of 120 is out of the normal range. Normal range is about 55 to 80 bpm. So it is not a DOT/FMCSA issue but a general health related question that the CME is evaluating.
So there isnât a requirement on dot pulse rate thatâs states your pulse has to be under 100? I live in Texas .
@ Bernice
Doctors and CME’s know that a normal heart rate is in the 60 to 75 bpm as normal. If your situation is as stated before, then a note from your primary physician indicating that your bpm is normally high, then the CME can take the available information into consideration.
My question is for my Husband . He took his DOT exam 2 years ago and for the first time failed it. He was given the 3 month card . now he has to do his physical every year .His blood pressure even with meds still has spikes every now and then we still can not figure out why. He is afraid he will fail A DOT exam when he goes in . Is he eligible for a 3 month certificate again if he fails or will he just be disqualified . We did not know if he could get another 3 month card after having one 2 years ago and being on blood pressure meds. Thank you for info you can give us .
@ Tina
FMCSA will allow a one time three month card for the driver to get his issue under control. If your husband is on high blood pressure medication, then his physical will be good for one year at the time. It is up to the examining CME as to whether he grants another three month card if he feels that the driver can have his situation under control within the time frame, but do not count on it. If he fails due to blood pressure, he is not disqualified. He simply needs to get his pressure under control and then re-take the examination.
I just had a quick question and couldn’t find an exact answer. My husband requires a DOL physical for his job even though he doesn’t need or have a CDL to drive his work vehicle. He was diagnosed with hypertension when he first got certified. His BP was 170/110 then. He also found out he has type 2 diabetes. He was originally certified for 3 months and then given the full year after he started treatment. He has been on medication and and his diabetes is well controlled he isn’t on insulin. His BP ranges any where from 155/90 to 135/80. With these readings would he be able to get recertified? We live in WA.
@ Rachel P
He will need a bp reading below 140 / 90. His diabetes will raise questions, but should only require proper documentation from his treating physicians. If all else checks out in the normal ranges he should do fine for a one year medical card. Also, he falls under the states variances and guidelines, not DOT/FMCSA. Some states adopted FMCSA guidelines and still have their own guidelines for non-cdl holders.
Thanks for the response. We still have 5 months before his recert is due so we have time to work on lower his BP even more.