Hypertension (High Blood Pressure) Guidelines & Advice

Last Updated: Jun 15, 2017

What New Truck Drivers Need To Know About Hypertension:

CDL drivers with high blood pressure can be given medical certification to drive and will have to re-certify at least every year, rather than every 2 years. They will have to keep their blood pressure under 140/90, with or without medication.

In a nutshell, Hypertension is high blood pressure. Blood pressure is the force of blood pushing against the walls of arteries as it flows through them. Uncontrolled blood pressure could keep a truck driver out-of-service , per the DOT.

The Medical Examiner will electronically file a copy of your physical to the DOT , and it will become part of your driving record in the Commercial Driver’s License Information System (CDLIS). If your medical certification expires before providing your state agency with a valid one, your CDL privileges will be suspended.

You can read the full FMCSA physical exam guidelines here.

What Are The DOT Physical Blood Pressure Limits

Normally, your DOT medical certificate will be good for 2 years. Certain medical conditions, such as hypertension, require more frequent physical certification. According to the FMCSA , drivers returning to the medical examiner just for a blood pressure follow-up will NOT be subject to a full medical exam.

  • Stage 1 Hypertension: Blood Pressure 140/90 - 159/99.

    Drivers can receive a one-year certificate. After 1 year, if they are not at 140/90 or below, with or without medication, they can receive a non-renewable three month certificate. During this time, they must achieve BP of 140/90 or below to qualify for an extension of the one year certificate. If they do not reach 140/90, certification extension is suspended until BP is under 140/90. Recertification will be required every 12 months thereafter.

  • Stage 2 Hypertension: Blood Pressure 160/100 - 179/109.

    Drivers are only eligible for a three month certification. After three months, blood pressure must be 140/90 or lower, with or without medication, to receive the remainder of the 12 months from the date of the initial exam. If it is above 140/90, drivers are disqualified until BP is lowered. Recertification will be required every 12 months thereafter.

  • Stage 3 Hypertension: Blood Pressure 180/110+.

    Stage 3 hypertension is an automatic disqualification. On follow-up, if the blood pressure is at 140/90 or below, with or without medication, drivers may qualify for a six-month certificate – dated from the time of the initial disqualification. Then, recertification will be required every 6 months.

What Hypertension Prescription Drugs Am I Allowed To Take?

Neither the FMCSA nor the DOT keeps a "Master List" of prohibited prescription drugs, for ANY condition. It will be up to the decision of your doctor and the Medical Examiner to determine if the medication a CDL driver is taking will "adversely affect a driver's ability to operate a CMV safely", per the FMCSA.

What medications disqualify a CMV driver from being medically certified?

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.""

The Medical Examiner has 2 ways to determine if any medication a driver uses will adversely affect safe operation of a CMV:

1. Review each medication - prescription, non-prescription and supplement.

2. Request a letter from the prescribing doctor.

Ways That Truck Drivers Can Lower Their Blood Pressure Before Their DOT Physicals:

Drivers who have been flagged as having, or know they have, high blood pressure, aside from using prescription medication to control it, can use specific practices to help reduce it. As you will be given yearly physicals, at least, these suggestions should generally improve your overall health and help make the physical less of a concern.

On the day of your physical, drivers who have high blood pressure (hypertension) concerns should: In no way should drivers try to hide, or "cover up", high blood pressure or any other condition. Always be up front about any medical concerns you may have. In the long run, they will all catch up to you.

  • Avoid caffeine, smoking, and alcohol -

    All of these have been proven to increase blood pressure, especially in the short-term.

  • Hydrate/Drink Water -

    When our bodies don't get enough water, this could lead to increased sodium (salt) retention. High levels of salt have been shown and medically accepted to directly increase blood pressure.

  • Eat a banana-

    Potassium has been shown to help lower BP, both short-term and long-term. Blood pressure may drop within an hour or 2 of eating a potassium-rich food. The top potassium rich foods include: bananas, potatoes, white beans, leafy greens and dried apricots.

  • Drink Beet Juice -

    Seriously. A recent study by the American Heart Association showed that, without any other diet changes, beet juice can lower blood pressure by an average of 4-5 points, within an hour or 2. Beet juice should be easily acquired at Wal-Mart, etc.

  • Deep Breathing Exercises -

    Ongoing clinical studies are showing that deep breathing/meditation can help lower your blood pressure.

  • Take a nap/Relax -

    A 45-minute nap during the day could help lower your blood pressure, expecially if you are feeling stressed about it, studies have demonstrated.

Please remember to check with your doctor before embarking on any radical lifestyle changes.

Hypertension Prevention and Management Between Physicals/Leading Up To Physical:

If you have been diagnosed with high blood pressure, or if you know you have it, there are ways in the months (or year) leading up to your next physical that, along with medication, will help reduce your BP. Aside from your DOT physical, these are also ways to improve your health and well-being, in general:

  • Exercise/Lose Weight:

    30 to 60 minutes of exercise per day can for those who already have hypertension can bring it down to safer/normal levels. Avoid trying to pack it all into a day or 2, as long, sudden bursts of strenuous physical activity can actually be harmful to your heart and its health. In general, the more weight you lose, the lower your blood pressure. Losing weight also makes any blood pressure medications you're taking more effective.

  • Eat a healthier diet:

    Many doctors recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan, which is based on studies sponsored by the National Heart, Lung, and Blood Institute (NHLBI). Requiring no special foods, it emphasizes fruits, vegetables, and low-fat or fat-free dairy. It also limits salts, sweets, and red meats. Much of DASH is common eating sense, but pays special attention to the dietary needs of hypertensives.

  • Reduce Sodium (Salt) In Your Diet:

    Excessive salt intake has been shown to increase blood pressure, long and short-term. When reading food labels, choose low-sodium alternatives, if possible. Any processed or fast food will generally be loaded with salt, so should be avoided if possible.

  • Limit Alcohol Intake:

    Generally, truck drivers wouldn't be doing much drinking in the first place, but regular, moderate drinking can actually raise your blood pressure and also reduce the effectiveness of your blood pressure medications. Binge drinking (having 4 or more drinks in a row) could cause sharp, sudden increases in blood pressure which could put people who already have hypertension in serious risk.

  • Reduce Caffeine Consumption:

    Increased caffeine intake has been shown to increase blood pressure, at least temporarily, in some people, but science is still unsettled on it. Your best bet is to monitor your blood pressure for any effects caffeine may have, and adjust accordingly.

  • Avoid Smoking/Nicotine:

    Aside from the many other ways that smoking damages your health, the nicotine in tobacco products can raise your short-term blood pressure, and regular users of tobacco will have constantly elevated BP.

  • Relax:

    Especially when you are actually going through, or getting close to, the physical process. Stress releases hormones into the blood which cause the heart to beat faster and heart rate to rise, which could give high blood pressure readings. In general, eliminating stress and/or its triggers will help with your general wellness.

Hypertension and Health Implications:

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

Hypertension Medical Effects:

Left untreated, hypertension will lead into serious conditions such as:

  • Arteriosclerosis Arteriosclerosis is the thickening, hardening and loss of elasticity of the walls of arteries. This process gradually restricts the blood flow to one's organs and tissues and can lead to severe health risks.
  • Heart attack
  • Stroke
  • Enlarged Heart
  • Kidney damage Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden. These damaged arteries are not able to deliver enough blood to the kidney tissue.

Generally, hypertension does not show any symptoms, so you might not know if you have it. Some possible symptoms may include: *****As always, consult with your doctor if you have any questions about your health. We are totally not medical professionals.*****

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


Commercial Driver's License (CDL)

A CDL is required to drive any of the following vehicles:

  • Any combination of vehicles with a gross combined weight rating (GCWR) of 26,001 or more pounds, providing the gross vehicle weight rating (GVWR) of the vehicle being towed is in excess of 10,000 pounds.
  • Any single vehicle with a GVWR of 26,001 or more pounds, or any such vehicle towing another not in excess of 10,000 pounds.
  • Any vehicle, regardless of size, designed to transport 16 or more persons, including the driver.
  • Any vehicle required by federal regulations to be placarded while transporting hazardous materials.


Compliance, Safety, Accountability (CSA)

The CSA is a Federal Motor Carrier Safety Administration (FMCSA) initiative to improve large truck and bus safety and ultimately reduce crashes, injuries, and fatalities that are related to commercial motor vehicle


Federal Motor Carrier Safety Administration

The FMCSA was established within the Department of Transportation on January 1, 2000. Their primary mission is to prevent commercial motor vehicle-related fatalities and injuries.

What Does The FMCSA Do?

  • Commercial Drivers' Licenses
  • Data and Analysis
  • Regulatory Compliance and Enforcement
  • Research and Technology
  • Safety Assistance
  • Support and Information Sharing


Department Of Transportation

A department of the federal executive branch responsible for the national highways and for railroad and airline safety. It also manages Amtrak, the national railroad system, and the Coast Guard.

State and Federal DOT Officers are responsible for commercial vehicle enforcement. "The truck police" you could call them.


Commercial Motor Vehicle

A CMV is a vehicle that is used as part of a business, is involved in interstate commerce, and may fit any of these descriptions:

  • Weighs 10,001 pounds or more
  • Has a gross vehicle weight rating or gross combination weight rating of 10,001 pounds or more
  • Is designed or used to transport 16 or more passengers (including the driver) not for compensation
  • Is designed or used to transport 9 or more passengers (including the driver) for compensation
  • Is transporting hazardous materials in a quantity requiring placards


Abnormally high blood pressure.


Dispatcher, Fleet Manager, Driver Manager

The primary person a driver communicates with at his/her company. A dispatcher can play many roles, depending on the company's structure. Dispatchers may assign freight, file requests for home time, relay messages between the driver and management, inform customer service of any delays, change appointment times, and report information to the load planners.


The Commercial Driver’s License Information System (CDLIS) is a nationwide computer system that enables state driver licensing agencies (SDLAs) to ensure that each commercial driver has only one driver’s license and one complete driver record.

A drivers file will include their driving record as well as their medical certification status.


Drive-A-Check Report

A truck drivers DAC report will contain detailed information about their job history of the last 10 years as a CDL driver (as required by the DOT).

It may also contain your criminal history, drug test results, DOT infractions and accident history. The program is strictly voluntary from a company standpoint, but most of the medium-to-large carriers will participate.

Most trucking companies use DAC reports as part of their hiring and background check process. It is extremely important that drivers verify that the information contained in it is correct, and have it fixed if it's not.


Hours Of Service

HOS refers to the logbook hours of service regulations.


Operating While Intoxicated


When a violation by either a driver or company is confirmed, an out-of-service order removes either the driver or the vehicle from the roadway until the violation is corrected.


When a violation by either a driver or company is confirmed, an out-of-service order removes either the driver or the vehicle from the roadway until the violation is corrected.

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