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Home Âť DOT Regulations for Blood Pressure and Hypertension

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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”.

403dPlease 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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Comments

  1. Mark says

    April 12, 2024 at 6:13 pm

    My blood pressure is 150/60. I’m taking meds for it, will I be able to get a one year card or will I be restricted to a 3 month card

    Reply
    • Trucker Docs™ says

      April 13, 2024 at 9:04 am

      @ Mark
      DOT/FMCSA for class A cdl holders. Blood pressure must be 140/90 or below. On bp meds, medical card good for one year at the time. Higher than 140/90 and on meds, a ‘one time’ 3 month medical card to get bp into the normal range.

      Reply
  2. Wayne K H says

    February 8, 2024 at 6:32 pm

    I had a fall and during ct scan there was an incidental finding of past silent ( I have never had any symptoms)stroke. When I renew medical card in a few months, how will the doctor decide what to do. As in, how will they know when it’s been a year? I already take Xaralto for a different condition and hospitality said there wouldn’t be anything else they would do. This could have been 6 months ago, 10 years ago or more.

    Reply
    • Trucker Docs™ says

      February 9, 2024 at 8:55 am

      @ Wayne K H
      Your medication will raise some questions and any supporting medical documentation regarding the silent stroke will be very helpful in the CME’s decision making process.

      Reply
  3. Kenneth McG says

    January 12, 2024 at 10:22 pm

    The doctor I used said you can get a 2yrs cert with blood pressure meds. They said it was just passed I can’t find anything on this I’m not on meds with 2yr cert wondering if this is ture

    Reply
    • Trucker Docs™ says

      January 13, 2024 at 4:16 pm

      @ Kenneth McG
      There was discussion with the FMCSA advisory board regarding a change, but to our present knowledge it is still a one year card for any blood pressure medication.

      Reply
  4. Dan N says

    August 25, 2023 at 12:42 pm

    My bp is at 114/78, yesterday it was 124/83,,,,because I wouldn’t shut up,,, Still good enough to pass correct? Doctor is determined that I have high blood pressure. She is basing this off old information from my medical files in the cloud. Completely illegal to do that. When I asked for my medical records for that day she said that she deleted my file. This is a federal violation. Are you going to tell me to brush it off and just go somewhere else?

    Reply
    • Trucker Docs™ says

      August 26, 2023 at 9:06 am

      @ Dan N
      Sounds like you need to speak with legal council on this matter.

      Reply
      • Andrew W says

        September 17, 2023 at 10:32 pm

        If I have a reading lower than 140/90 WITH BP meds and then at my next annual receive a reading slightly higher than 140/90 WITHOUT BP meds, will I receive a 3 month card to get it back under control?

        Reply
        • Trucker Docs™ says

          September 18, 2023 at 6:45 am

          @ Andrew W
          Most likely.

  5. tony says

    August 3, 2023 at 7:43 pm

    hello i went to my dr today not dot physical and i have high blood presure dr put me on lisinopril 20mg for blood pressure and certirizine for dust allergies and a cream metronidazole 0.75 to put on my face for allergies my question is are these prescriptions accepted ? by a dot dr physical ? and when i go to my dot physical in two weeks just bring the medication and anything else thank you

    Reply
    • Trucker Docs™ says

      August 4, 2023 at 8:02 am

      @ tony
      You should be fine. The examiner may want some additional information. If he does, he will let you know what he needs.

      Reply
      • Tony says

        August 8, 2023 at 7:41 pm

        Hi thanks for your reply I filled out the long form put my prescriptions I mentioned and my cpap use the dr only checked my cpap use and being that my blood pressure I guess all was good I only got a one year medical but that’s enough to get the job in this year I am going to focus on losing weight and eating healthier all the best and thanks again

        Reply
  6. Audriana S. says

    July 17, 2023 at 3:47 pm

    If a driver is given a one-time certification of three months to reduce his or her blood pressure, what happens if the drivers blood pressure is high again when they go in for medical exam?

    Reply
    • Trucker Docs™ says

      July 18, 2023 at 9:21 am

      @ Audriana S
      After the first and only 90 day card, no new medical card can be issued until the bp is under control.

      Reply
      • Audriana S. says

        July 18, 2023 at 11:29 am

        Will their class A license get taken away? Or they just won’t be able to operate certain vehicles until the bp is under control and they are able to complete/pass a medical certification exam?

        Reply
        • Trucker Docs™ says

          July 19, 2023 at 8:02 am

          @ Audriana S
          CDL will be suspended. Highly unlikely that the state will revoke the cdl, but they will put it into suspension until a valid medical card is presented. No driving privileges. Confirm with your local DLD.

  7. Ed d says

    April 30, 2023 at 3:25 pm

    Can a driver take Clonidine for hypertension and get dot certification card (medical card )

    Reply
    • Trucker Docs™ says

      May 1, 2023 at 7:47 am

      @ Ed d
      Yes, but it will reduce your medical card to one year at the time.

      Reply
  8. Justin E says

    April 25, 2023 at 3:51 pm

    If I had high blood pressure, but have lost weight and no longer take blood pressure medication (since my BP is in normal range) can I go back to a every two year examination or am I forever at one year exemption? If I can get back to two year re certifications what needs to be done (I live in CA).

    Reply
    • Trucker Docs™ says

      April 26, 2023 at 8:11 am

      @ Justin E
      It’s a weird position because the forms ask if you have ever had a history of HBP. Then the CME has to make the final call based on the documentation you can provide from your physician.

      Reply
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