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 drove a truck OTR for 13 years and 7 years ago i had two heart attacks. they had went in and put in 3 stents in my heart. my cardiologist had me on about 10 different medications mainly for high blood pressure and colesterol. i didn’t like the thought of having to take so many medications because some of them were to counter the side effects of the other and so on and so forth. i felt like i was walking around in a fog all the time. i no longer use that doctor and i took matters into my own hands. i exercised and dieted and lost nearly 50 lbs and i no longer take any medication except the daily aspirin and my blood pressure is below the guidelines. my question is since everything is within the guide lines do i still need the medical release form and if so who can i get it from since i no longer use that pill pushing doctor? can i go to my primary doctor and get it or do i need to go to a cardiologist? The reason i’m asking is that my cdl’s had expired about a month of my second heart attack and i’m considering going back to driving again. i just need to know what i need to do to in order to get them back as far as my medical situation.
@Chris
You will need to have a medical release form filled out by your primary doctor, explaining that you no longer need the medications that your were originally prescribed. Since you had a heart attack, 2 in a short time frame, you will need a copy of your last stress test, as long as it is within the past two years. With all this information in hand, you should be able to return to driving. Good Luck
I have a history of high blood pressure and I am currently on BP medication. When I went for my re-certification,my BP was 148/77. I was given 3 months and was told by the doctor to visit my PCP and get my BP under control before my 3 months expires. What happens if my BP is still above 140/90 when I return in 3 months? Do lose my certificate or do I get another 3 months?
@Tony
If you were on blood pressure medication when you took the last DOT examination, then you just got your only, one time, 3 months card to get your BP under control. If you don’t get it under control, you do not get another 3 months to continue trying. You would be disqualified until it is under 140/90.
In December 2014 new Blood Pressure Guidelines were published in the Journal of American Medical Association (JAMA) and they now say that individuals over age 60 are not considered to have high Blood Pressure in the pressure is 150/90 or lower.
To whom can I write to or contact at the Department of Transportation and ask if they will implement these guidelines for CDL Drivers who are over 60 who have blood pressure readings that fall in the 140/90 to 150/90 range?
Thank you.
@David
Well I would start with the DOT and the FMCSA Advisory board. Just Google “FMCSA advisory board” and go from there.
I recently went to a clinic for chest pain. They transported me to a hospital for three days, and was told they were going to put a stent in.Fortunately they did not have to put a stent in but I was prescribed two blood pressure meds and a cholesterol med.I am supposed to be starting a new job pulling tanker hazmat freight. Will these medications keep me from pulling Hazmat?
@Kurt
You don’t give much information regarding what medications. But as a general statement, most of the HBP medications are well within the parameters of the DOT that would allow you to drive.
Your medical card needs to be redone since the trip to the hospital and you will need a medical release form filled out by your primary doctor. The CME will want to make sure you are doing OK on the medication.
Medical cards with medications for HBP will be limited to one year.
Male, 61. Has diabetes, insulin shot daily. Not over the road driver..mechanic, drives vehicles in and out of shop. Failed DOT physical in N.C. Works in Virginia. Can he get some kind of waiver to drive truck in and out of shop onto parking lot.
@Teresa
He should qualify for intra-state only and be able to do the job you are describing without any thing other that a medical release from his primary doctor and if the state needs it, an insulin waiver for intra-state only.
My understanding is that driver licenses of whatever class are only required to drive on the public highways, and are not required to drive solely on private property such as described. Ditto with construction and farm equipment which only cross public highways occasionally. Laws vary from state to state — I would research the laws of your state online, and print out a copy for the mechanic.
sometimes this bp problem is bs. I am close to 60 years old, I workout 4 or 5 days a week, I am very lean and I am in very good condition. I have checked my blood pressure many times and I have a monitor I check it all the time . went to get cdl med. and blood pressure was about 160 over 90 two times go home and check over the next 3 or 4 days and never over 128/65. the only way to get a true and honest reading is with a abpm monitor, I have never had high bp except at the doctors office and the monitoring system they use was invented in 1896. The only fare way is 24 hr.abpm monitoring if you are suppected to have white coat system.
@Ed
FMCSA sets the guidelines at 140/90 or less.
I know plenty of drivers that have white coat syndrome and you’re right, it’s a pain. Try to find a doctor that you are comfortable with and see if he will take multiple reading throughout the examination. Your pressure should naturally reduce as you get more comfortable around them. Otherwise, try your idea, it sounds good to me, and see if your CME will accept the readings. Good Luck.
I think this big deal with a few blood pressure points is being blown way out of proportion. There are people whose b.p. is high whom lead good productive lives the only reason for this b.p. is aging. We all can’t be below 140/90 this is utterly ridiculous. All these cdl persons out of a job as hard as times are. # THE ESTABLISHMENT needs to get real. I don’t know could be I just hav’ent heard of a cdl driver losing control of his vehicle because his b.p. was high. On the other hand I have heard of people being prescribed bad batches of drugs that were meant to help them and having; shall we say adverse reactions causing and having accidents.
There is no point in working in government if you can’t make people miserable. Many in the public sector excel in this art form. This thread is only one such manifestation.
I have kideny failure and am on dialysis receiving treatment 3x a week at a set time. My blood pressure is in the stage 2 hypertension range with medication and I can get a note from the physician that has been with me for 10 yrs to explain there is no danger in me driving. Will I be able to get medical clearance to get my CDL? Thanks for your time.
@Cory
Given your situation, be prepared to answer a lot of questions.
Start with a medical release form from your primary doctor.
Second, consider driving intra-state only. This will allow you to drive and still be able to maintain yourself.
Be aware that you will have to have your blood pressure under 140 / 90 and a medical release form from your blood pressure doctor also. Good luck.