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 take medication for hypertension for over a year now. I passed my medical today and was charged the DOT$119 fee. CVS Medic Clinic also tacked on $219.46 fee due to me having hypertension. This is my first go with getting CDL in NC. Is this extra charge normal? They did file the $219 with insurance.
@ Herman T III
CVS may have just screwed your insurance company for $220.00 for nothing. And if your insurance company does not pay, then they will call on you to pay. Nothing about this is correct.
If I downgrade to a class D license, do the Blood pressure numbers still have to be below 140/90 ?? And will I have to retest to go down to a class D license?
@ Terry
If for some reason you need a medical card, then bp will come into play, otherwise no issue other than your health. Rather doubtful you will need to retest for a class D license.
Assuming you need a medical card to operate a vehicle between 10k and 26k GVWR (under CDL but regulated by USDOT), the limits are the same.
There is a consistent issue with DOT exams where the candidate doesn’t speak English. Guidelines appear rather vague. What are your thoughts?
@ Vinsk
DOT/FMCSA guidelines indicate that the driver should be able to speak and understand English. (even if it is broken) We try to work with them. They should have the ability to comprehend the language and respond. Working through a translator could be helpful, but is not the final solution. We try to find out how much of the language they understand and can communicate back to us clearly.
Will the doctor accept a doctor note from another doctor for bp
@ Ken
Typically not. If the CME knows you and understands ‘white coat’ maybe, but don’t hold your breath on it. DOT/FMCSA for a class A cdl holder wants a present/in office reading.
I get white coat syndrome when it comes to my physical. Just took a dot physical. BP first time was 168/92. Second time was 152/82. Was only given 90 days.i asked can you test again in a little bit BP was going down. Was told no we can’t wait to get BP numbers where we want them. on BP meds since 2017. Getting second opinion.
I have 90 day med card and am concerned
What will happen if it’s high again when I retest. I have a doctors appointment to address the situation but after the test which is today.
@ Tony S
For a class A cdl, you will need to have your pressure below 140/90 before you can re-test for your DOT medical card.
I don’t believe this is true. You need to be under 140/90 to get a 2 year card, but you can still get a 1 year card with uncontrolled stage 1 hypertension
@ Ryan S
Can you point me in the direction of said ruling within DOT/FMCSA guidelines and regulations. Thanks
I took my DOT physical today and my blood pressure was 132/89 98 and the doctor gave me a medical card for one year I don’t think that’s right
@ William
Which is it 132/89 or 132/98 ? 132/89 is passing with no difficulty, according to DOT/FMCSA. 132/98, DOT/FMCSA requires a one year medical card to get your bp below 140/90.
If I’m on 1 year for hypertension & taking approved meds for it but have never been given a 90 day card & it’s above 140/90 at a physical will I get a 1 time 90 day card? Or a suspension?
@ Patrick
Most cases, a one time 90 day to get bp under control.
Even if I’ve been on 1 year due to being on BP meds?
@ Patrick
If it is the first time, then yes. If you have had this issue previously, then the CME may hold back on the 90 day card. Be aware, if a 90 day card is issued, when you can pass with a normal bp you will only get the remainder of the one year card.