Blood Pressure Requirements For The DOT Physical

Truck drivers must pass a DOT physical to obtain their CDL. Checking for high blood pressure (or Hypertension) is a routine part of these physicals. And while high blood pressure can be disqualifying, it doesn't need to be if you manage it properly. While this can be hard to do while living the trucker life, medication and commitment to a healthy lifestyle can be a huge help.

The limits for each stage of Hypertension are as follows:

• Normal: Blood pressure needs to be under 140/90, with or without medication.
• Prehypertension: Blood pressure ranges from 120/80 – 139/89.
• Stage 1 Hypertension: Blood pressure between 140/90 - 159/99, 1-year medical certificate, must be renewed every 12 months.
• Stage 2 Hypertension: Blood pressure between 160/100 - 179/109, a 3-month medical certification. Disqualification happens if the condition is not under control within three months. You must renew your medical card every 12 months.
• Stage 3 Hypertension: Blood pressure at or above 180/110: Automatic disqualification, 6-month certification once blood pressure is under control, and you must renew your medical card every six months.

Hypertension and Health Implications:

People with Hypertension have a higher risk for heart disease and other medical problems. Regular blood pressure checks and treatment will help avoid serious complications from this condition.

Hypertension Medical Effects:

Left untreated, Hypertension will lead to serious conditions such as:

• Arteriosclerosis
• Heart attack
• Stroke
• Enlarged Heart
• Kidney damage

Generally, Hypertension doesn't show symptoms, so drivers might not know if they have it. Some possible symptoms may include:

• Severe headache
• Pounding in the chest, neck, or ears
• Shortness of breath
• Irregular heartbeat
• Nosebleed
• Tiredness
• Confusion
• Vision changes
• Blood in urine

How is Blood Pressure Measured?

pressure is represented by two numbers. The first number measures the pressure in the arteries when the heart beats and fills them with blood, called systolic pressure. The second number measures the pressure in the arteries when the heart rests between beats and is called diastolic pressure. A typical heartbeat is expressed like this 120/80, with the former number representing systolic pressure and the latter number representing diastolic pressure.

What Are Blood Pressure Limits for The DOT Physical?

High blood pressure, or Hypertension, is commonly broken into three stages based on a driver's systolic blood pressure (SBP) and diastolic blood pressure (DBP). Anything below 120/80 is considered normal. Prehypertension is in the range of 120-139 over 80-89. Anything above that range is considered stage one Hypertension. Drivers can still be approved for a CDL through stage three Hypertension.

How Does High Blood Pressure Affect Truck Driving?

There is strong evidence that Hypertension drastically increases the risk of heart disease and that effective treatment reduces cardiovascular illness and death. To be certified to drive, the driver should have ongoing hypertension management. Drivers on hypertension medication can be medically certified to drive if their medication does not produce side effects that impair their ability to drive safely.

What if a Trucker has Hypertension?

For drivers with high blood pressure, getting a CDL can be challenging. For example, drivers will need to renew their medical card at least once every year instead of the standard recertification every two years. Likewise, drivers will have to keep their blood pressure under 140/90 (prehypertension or better), with or without medication.

Can You Pass DOT Physical with High Blood Pressure?

A history of high blood pressure alone will not disqualify a driver. A person will be eligible to drive if they can show their blood pressure is well managed, and subsequent DOT medical exams prove this.

Typically, this means that drivers with Hypertension will need to recertify medically more often. How often will depend on what stage of Hypertension a driver has, with more severe cases requiring more frequent medical examinations.

However, a blood pressure reading greater than 180/110 will automatically disqualify a commercial driver.

What Blood Pressure Level Will Cause a Failed a DOT Physical?

A history of high blood pressure will not disqualify a driver from getting their CDL. However, there are limits placed on how high a driver's blood pressure can be for each stage of Hypertension. Exceeding these limits can result in a driver's CDL privileges being suspended.

All drivers (without Hypertension) need to have a blood pressure under 140/90, with or without medication. Drivers with stage 1 hypertension will need their blood pressure to be between 140/90 and 159/99. These drivers will have a 1-year medical certificate and must renew their medical card every 12 months. Those with stage 2 hypertension have blood pressure readings between 160/100 and 179/109 and will be medically certified for three months. Disqualification will occur if the condition is not under control within three months.

Automatic disqualification occurs at stage 3 hypertension, which will be anyone with blood pressure at or above 180/110. Once your blood pressure is under control, drivers can apply for a medical certification that renews every six months.

The DOT requires all drivers to maintain control of their blood pressure with or without medication.

Can a Driver Reapply if They Fail the DOT Physical For High Blood Pressure?

Yes. However, drivers will need to get their blood pressure under Stage 1 or Stage 2 classification to pass the DOT physical.

How Often Do Drivers Take The DOT Physical If They Have High Blood Pressure?

It depends on the severity of the driver's blood pressure issues. For example, stage 1 hypertension requires annual physicals rather than the standard biannual exams. Stage 2 allows driving, but operators must work on lowering their blood pressure. If truckers are Stage 3, they must first lower their blood pressure before they can drive a CMV again.

How Can I Lower My Blood Pressure Before a Dot Physical?

High blood pressure can lead to a heart attack, stroke, and death. Lowering one's blood pressure even minimally could significantly reduce these risks.

Truckers suffering from long-term Hypertension have several ways to lower their blood pressure to bring their condition under control. They can include taking steps such as reducing the amount of sodium in the diet and exercising more regularly.

Many drivers want to make sure their blood pressure is under control on the day of the DOT physical. Some simple ways a driver can lower their blood pressure on the day of their physical include:

• Avoid caffeine, smoking, and alcohol
• Try IMST (Inspiratory Muscle Strength Training)
• Stay hydrated and drink plenty of water
• Eat a banana (potassium has been shown to lower blood pressure)
• Drink beet juice
• Take a nap
• Enjoy relaxing activities
• Practice deep breathing exercises. (A video of a simple "belly breathing" routine can be found here.)

What do Drivers with Hypertension Have to Do To Maintain their CDL?

Per DOT regulations, uncontrolled blood pressure can keep a truck driver out of service. Drivers with Hypertension must prove they have their condition under control when they recertify their CDL.

When CMV drivers take their DOT physical, the Medical Examiner will electronically file a copy of the physical to the DOT. It will become part of the driver's record in the Commercial Driver's License Information System (CDLIS).

If your medical certification expires, the state may suspend your CDL privileges. Thus, it is crucial to keep your medical certification current. A driver's record in the CDLIS will reflect this. (For more on the CDLIS , please see DOT's explainer here.)

What Hypertension Prescription Drugs Are Truckers Allowed to Take?

Neither the FMCSA nor the DOT keeps a "Master List" of prohibited prescription drugs for any condition. Your doctor and the medical examiner will determine if your medication will "adversely affect a driver's ability to operate a CMV safely."

Per the FMCSA:

"A driver cannot take a controlled substance or prescription medication without a prescription from a licensed practitioner. If a driver uses a drug identified in 21 CFR 1308.11 (391.42(b)(12)) or any other substance such as amphetamine, a narcotic, or any other habit-forming drug, The driver is medically unqualified. There is an exception: the prescribing doctor can write that the driver is safe to be a commercial driver while taking the medication. In this case, the Medical Examiner may but does not have to certify the driver. Any anti-seizure medication used for the prevention of seizures is disqualifying. Methadone use is disqualifying."

Medical examiners have two ways to determine if any medication a driver uses will adversely affect the safe operation of a CMV:

• 1. Review each medication - prescription, non-prescription, and supplement
• 2. Request a letter from the prescribing doctor.

Types of Blood Pressure Medication

There are several different types of blood pressure medication designed to target various aspects of Hypertension. Working with a doctor will help truckers find which one works best for them. Sometimes the right solution may be a combination of medications. Below are some common types of blood pressure medications that drivers may use as they work to get their high blood pressure under control:

• Diuretics
• Beta-blockers
• ACE inhibitors
• Calcium Channel Blockers
• Alpha-blockers
• And more!

What Should Truckers Know About Blood Pressure Medication?

CMV drivers should always be on the lookout for possible adverse side effects or reactions when taking medication prescribed to them by a doctor. Drivers on hypertension medication can be medically certified to drive if their medication does not produce side effects that impair their ability to drive safely.

*** Never take prescription medication unless you have a prescription for it. The results of misusing licit drugs can be disastrous! ***

How Much Is A Blood Pressure Monitor?

If a CMV driver is on the cusp of high blood pressure, the best thing to do is take charge of the health situation. Adopting healthier habits is a fantastic way to start. It may also help to invest in a blood pressure monitor.

There are many options for at-home blood pressure monitors. Here is a great article about How to Pick a Home Blood Pressure Monitor. Inexpensive, high-quality monitors are available. Drivers can expect to spend as little as $20 and up to $200.

Straight From the Trucker's Mouth: Trucking Truth Forum Stories

User Jeff L. from Montgomery, TX on the blood pressure testing experience:

…mine was high and they let me take it three times because I normally am in the green. If I would have had to go with my first one, I would have only gotten a one-year card, but barely passed to get the two year card. Working drastically on trying to get back in shape, jogging, eating a proper diet, and taking supplements to support healthy BP.

User Silverbolt from Grand Rapids, MI on maintaining a healthy lifestyle:

…. I'm a major proponent of the so-called 'primal' or 'paleo' lifestyle. Something else to consider for weight loss and reining in blood pressure, IMO, is something called 'intermittent fasting. This is a lifestyle change which I imagine would go very well with truck driving. More recent info on intermittent fasting is here.

User Rick S. from Fort Lauderdale, FL on the 3-month card:

The problem with the 3 month card is - YOU ONLY GET ONE. And your Hypertension really must be Stage II (160-179/100-109) for this to happen.

User Greenhorn Trucker from MI on being honest about blood pressure issues:

Most definitely tell the doc that you are taking them, you will get a one-year card max, but better than being disqualified for not disclosing the information either. I can say though that my BP was extremely high (240/140) but now I am down to a more normal range (120's-130's/80ish) and I still qualified for a one year card, however if it is high when they take the first reading ask them to let you relax a bit and get it down (white coat syndrome sometimes makes for false readings). I did make some dietary changes though too to help lower my numbers a lot as well such as; not using salt on food, drink 1-2 sodas max a day (though I hardly touch the stuff now), drink lots of water (8-12 16oz a day), I don't drink coffee so that was easy to not worry about, yoga breathing (it is very relaxing and easy to do), limit candy and other junk food, and the big one not letting my temper get out of control. I would also suggest making one change at a time rather than doing many all at once, because doing too much will actually stress you out causing your blood pressure to become elevated until it has fully adjusted.

Sources to Incorporate:

FMCSA Medical Guidelines Overview> FMCSA Medical Guidelines Overview">FMCSA Medical Guidelines Overview

FMCSA Medication Issues Overview

CDC Guide to High Pressure

CDLIS Homepage">CDLIS Hompage

How to get blood pressure down to 120

DOT Physical Guidelines