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Blood Pressure | DOT Medical Certification

The DOT disqualifies drivers with a systolic (higher number) blood pressure at or above 160 or a diastolic (lower number) pressure at or above 90. Drivers with a diagnosis of hypertension or those on medication to control blood pressure must provide a detailed cardiovascular evaluation for DOT consideration.

Proper documentation is essential to obtain a medical certificate.

 Blood Pressure Optimal Normal High Normal Hypertension DOT Limitations*  DOT Maximum**
 Systolic (top #) <120 <130   130-139   140 + 161-180   180 or higher
 Diastolic < 80 < 85    85-90    90 +  91-140   104 or higher

Commercial drivers who present for certification with a normal BP reading, but who are taking medication for hypertension are certified on the same basis as individuals who present with BPs in the mild to moderate range.

If your blood pressure is elevated, speak with your physician about how to reduce your blood pressure.  It may be possible to reduce your blood pressure by limiting the sodium (salt) in your diet, losing weight if overweight, taking medication, limiting your alcohol intake and/or increasing your physical activity.  MORE INFO

Although reducing your blood pressure by lifestyle modification is preferred, it may be best to utilize medication initially to reduce the risk for arterial damage and stroke.  Eventually exercise and diet may permit you to discontinue the medication.

Medications for Hypertension

*DOT LIMITATIONS Blood Pressure between 161-180 systolic and/or 91-104 diastolic.

  1. The driver is given a 3-month period to reduce the BP to less than or equal to 160/90; the medical examiner should state on the medical certificate that it is only valid for that 3-month period.
  2. If at any time during or by the end of this 3-month period the BP is found to be less than or equal to 160/90, a medical certificate may be issued for a 1-year period. However, the BP must confirm blood pressure control in the third month of this l-year period.
  3. The individual must be certified annually thereafter.

**DOT MAXIMUM Blood Pressure greater than 180 systolic and/or greater than 104 diastolic.

  1. The driver should not be qualified, even temporarily, until the BP has been reduced to less than 181/105.
  2. Once the individual's BP is below 181 and/or 105, the driver may be issued one 3-month certificate. During this 3-month period, the BP must be reduced to less than or equal to 160/90.
  3. If at any time during or by the end of this 3-month period the BP is found to be less than or equal to 160/90, a medical certificate may be issued for a 6-month period. However, the BP must be confirmed in the third month of this 6-month period.
  4. For an initial BP greater than 180 and/or 104, documentation of continued control and re-certification should be made every 6 months and the expiration date stated on the medical certificate.


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