Question About Blood Pressure

I recently had my DMV physical and my blood pressure was 130/90. Dr. issued me a 1 year medical cert, I was alright with that , figured I had a year to get my blood pressure under control. Then I was told that once you get an annual cert you cannot get another 2 year cert for the rest of your driving career, even if you get your blood pressure down.Is this true?

I recently had my DMV physical and my blood pressure was 130/90. Dr. issued me a 1 year medical cert, I was alright with that , figured I had a year to get my blood pressure under control. Then I was told that once you get an annual cert you cannot get another 2 year cert for the rest of your driving career, even if you get your blood pressure down.Is this true?

I don't recall hearing anything about that but I can't say for sure. We have a ton of information in our wiki on Blood Pressure Requirements For The DOT Physical and all of the various aspects of the DOT Physical.

If your BP is controlled BY MEDICATION - then you can only get a 1 year cert.

Hypertension § 391.41(b)(6)

A person is physically qualified to drive a commercial motor vehicle if that person:

Has no current clinical diagnosis of high blood pressure likely to interfere with ability to operate a commercial motor vehicle safely. Hypertension alone is unlikely to cause sudden collapse; however, the likelihood increases when target organ damage, particularly cerebral vascular disease, is present. This regulatory criteria is based on FMCSA's Cardiovascular Advisory Guidelines for the Examination of CMV Drivers, which used the Sixth Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (1997).

Stage 1 hypertension corresponds to a systolic BP of 140-159 mmHg and/or a diastolic BP of 90-99 mmHg. The driver with a BP in this range is at low risk for hypertension-related acute incapacitation 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 140/90.1f less than 160/100, certification may be extended one time for 3 months.

A blood pressure of 160-179 systolic and/or 100-1 09 diastolic is considered Stage 2 hypertension, and. the driver is not necessarily unqualified during evaluation and institution of treatment. 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. A blood pressure in this range is an absolute indication for antihypertensive drug therapy. Provided treatment is well tolerated and the driver demonstrates a BP value of 140/90 or less, he or she may be certified for one year from date of the initial exam. The driver is certified annually thereafter.

A blood pressure at or greater than 180 (systolic) and 110 (diastolic) is considered Stage 3, high risk for an acute BP-related event. The driver may not be qualified, even temporarily, until reduced to 140/90 or less and treatment is well tolerated. The driver may be certified for 6 months and biannually (every 6 months) thereafter if at recheck BP is 140/90 or less.

Annual recertification is recommended if the medical examiner does not know the severity of hypertension prior to treatment. An elevated blood pressure finding should be confirmed by at least two subsequent measurements on different days.

Treatment includes nonpharmacologic and pharmacologic modalities as well as counseling to reduce other risk factors. Most antihypertensive medications also have side effects, the importance of which must be judged on an individual basis. Individuals must be alerted to the hazards of these medications while driving. Side affects of somnolence or syncope are particularly undesirable in commercial drivers.

Secondary hypertension is based on the above stages. Evaluation is warranted if patient is persistently hypertensive on maximal or near-maximal doses of 2-3 pharmacologic agents. Some causes of secondary hypertension may be amenable to surgical intervention or specific pharmacologic disease. (See Cardiovascular Advisory Panel Guidelines for the Medical Examination of Commercial Motor vehicle Drivers at: http://www.fmcsa.dot.gov/rulesregs/ medreports.htm)

Rick

David C.

One answer: Run.

You are guaranteed to drop blood pressure 10-15 points in BP if you run 2 miles 3 days a week.

Of course get a physical check up from your doctor first

If your BP is controlled BY MEDICATION - then you can only get a 1 year cert.

Hypertension § 391.41(b)(6)

A person is physically qualified to drive a commercial motor vehicle if that person:

Has no current clinical diagnosis of high blood pressure likely to interfere with ability to operate a commercial motor vehicle safely. Hypertension alone is unlikely to cause sudden collapse; however, the likelihood increases when target organ damage, particularly cerebral vascular disease, is present. This regulatory criteria is based on FMCSA's Cardiovascular Advisory Guidelines for the Examination of CMV Drivers, which used the Sixth Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (1997).

Stage 1 hypertension corresponds to a systolic BP of 140-159 mmHg and/or a diastolic BP of 90-99 mmHg. The driver with a BP in this range is at low risk for hypertension-related acute incapacitation 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 140/90.1f less than 160/100, certification may be extended one time for 3 months.

A blood pressure of 160-179 systolic and/or 100-1 09 diastolic is considered Stage 2 hypertension, and. the driver is not necessarily unqualified during evaluation and institution of treatment. 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. A blood pressure in this range is an absolute indication for antihypertensive drug therapy. Provided treatment is well tolerated and the driver demonstrates a BP value of 140/90 or less, he or she may be certified for one year from date of the initial exam. The driver is certified annually thereafter.

A blood pressure at or greater than 180 (systolic) and 110 (diastolic) is considered Stage 3, high risk for an acute BP-related event. The driver may not be qualified, even temporarily, until reduced to 140/90 or less and treatment is well tolerated. The driver may be certified for 6 months and biannually (every 6 months) thereafter if at recheck BP is 140/90 or less.

Annual recertification is recommended if the medical examiner does not know the severity of hypertension prior to treatment. An elevated blood pressure finding should be confirmed by at least two subsequent measurements on different days.

Treatment includes nonpharmacologic and pharmacologic modalities as well as counseling to reduce other risk factors. Most antihypertensive medications also have side effects, the importance of which must be judged on an individual basis. Individuals must be alerted to the hazards of these medications while driving. Side affects of somnolence or syncope are particularly undesirable in commercial drivers.

Secondary hypertension is based on the above stages. Evaluation is warranted if patient is persistently hypertensive on maximal or near-maximal doses of 2-3 pharmacologic agents. Some causes of secondary hypertension may be amenable to surgical intervention or specific pharmacologic disease. (See Cardiovascular Advisory Panel Guidelines for the Medical Examination of Commercial Motor vehicle Drivers at: http://www.fmcsa.dot.gov/rulesregs/ medreports.htm)

Rick

If I read this right, if someone comes in with David C's numbers (130/90) a second year, they would get another 1 year card; however, if the lower number shows any increase (130/91 or higher), that person would get a 3-month card. This is based on my reading of the section pertaining to Stage 1 hypertension -

"Certification examinations should be done annually thereafter and should be at or less than 140/90.1f less than 160/100, certification may be extended one time for 3 months."

In other words, the answer to David's question is 'yes - once your blood pressure disqualifies you from getting a 2-year card, you will never be able to get a 2-year card'. The only thing that's a bit ambiguous is the inclusion of the word 'should' in the part of the Stage 1 section that I quoted (now I feel like Bill Clinton trying to explain what 'is' means, lol...)

If your BP is controlled BY MEDICATION - then you can only get a 1 year cert.

If I read this right, if someone comes in with David C's numbers (130/90) a second year, they would get another 1 year card; however, if the lower number shows any increase (130/91 or higher), that person would get a 3-month card. This is based on my reading of the section pertaining to Stage 1 hypertension -

"Certification examinations should be done annually thereafter and should be at or less than 140/90.1f less than 160/100, certification may be extended one time for 3 months."

In other words, the answer to David's question is 'yes - once your blood pressure disqualifies you from getting a 2-year card, you will never be able to get a 2-year card'. The only thing that's a bit ambiguous is the inclusion of the word 'should' in the part of the Stage 1 section that I quoted (now I feel like Bill Clinton trying to explain what 'is' means, lol...)

Typically - if you are on BP Meds - most M.E.'s will only issue a 1 year card - your BP will not meet regs WITHOUT MEDS - so they typically want you monitored. The rule seems "somewhat vague", but people I've spoken to, told me - you're on meds, you get a 1 year.

Now - I have "friends", that DON'T SAY they're on meds - go in and get below the 140/90 - and get a 2 year card. You DON'T HAVE TO GO TO THE SAME M.E. every year.

In the case of a COMPANY DOT PHYSICAL (at orientation), you drive on that one, until it expires. At that point - you can go WHEREVER YOU WANT and get your renewal, they don't pull you into THEIR DOCTOR to do it. If you SWITCH COMPANIES - you will get another physical, and a NEW CARD.

When I went to renew last year - I couldn't get down under the required number, after 2 visits. I got on meds, went back a week later - and they gave me a 1 year card (after I got under the number). I've since lost a bunch of weight - by the time I come up for renewal the end of April - I probably won't even need the meds any longer. So I will go back to the guy that did my card in '09 (instead of the expensive clinic around the coroner $40 vs $90), and get my renewal from him. At the time I got my ORIGINAL - I stated RIGHT ON THE FORM that I was on meds for BP, and he gave me a 2 year card ANYWAY.

NOW - the way the rule is written - if you DO HAVE between 140-149/90-99 - you're "supposed to get" a 1 year card as well. The M.E. I went to wouldn't do it - even AFTER I SHOWED THEM THE GUIDANCE for the rule. They told me they would give me a 3 month card - so I could get down under the 140/90.

REMINDER: Your LICENSING STATE DMV REQUIRES YOUR DOT MED CARD TO BE ON FILE. YOUR CDL WILL BE DOWNGRADED TO A CLASS E, IF THEY DO NOT HAVE IT ON FILE WHEN IT EXPIRES. MAKE SURE YOU FILE YOUR RENEWAL IN A TIMELY FASHION WITH YOUR STATE DMV. IF YOU GET CAUGHT DRIVING A CMV , WITH A DOWNGRADED LICENSE - IT IS "OPERATING A CMV WITHOUT A CDL". YOU CAN GET YOUR CDL PRIVILEGE SUSPENDED FOR A YEAR IF YOU GET CAUGHT.

Sorry for shouting - but's it's THAT IMPORTANT.

Rick

Sounds like you have at least 2 cases yourself of an examiner not following the regs - either not knowing them, or not caring (the 3-month is fairly obviously the latter, since you showed him the guidance)

Yours is 130/90 that's OK right? I thought if it is under 140 you get a 2 year card and 140 to 155 is the 1 year... I got the 2 year and mine was under 140

David's issue would most likely be with the bottom number - the regs call for BELOW 140/90, and whichever number is more 'out of spec' is most likely going to be the determining factor. By having EXACTLY 130/90, David is technically in stage 1 hypertension (according to the guidelines)

Sounds like you have at least 2 cases yourself of an examiner not following the regs - either not knowing them, or not caring (the 3-month is fairly obviously the latter, since you showed him the guidance)

Really wasn't going to argue at the time - I just needed my renewal done, so I didn't get downgraded. I could have "doctor shopped". I was going through a real stressful period at the time - and a lot of it was just the stress. I wasn't even (actively) planning on driving then, but I like to keep all my certs current - just in case.

It was also a clue that I needed to get back on BP meds, and go back on my diet. First time I walked in (unmedicated), I was a 145/110. I should be down in weight enough to come off the meds by the end of next month when I renew (at a different Dr.), otherwise - I just won't disclose.

When (if, leaning more towards when - LOL), I get out to get on with a company (probably by the summer), I'll just have to do another physical ANYWAY.

Rick