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.

  • A driver with a BP of less than 140 / 90 may be medically certified to drive for a two-year period.
  • 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.
  • A driver with a 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 onetime 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 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.
  • 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 be certified for 6 months and biannually (every 6 months) thereafter if at recheck BP is equal to or less than 140/90.

Chart indicating the acceptable time frame for various blood pressures as it relates to the DOT exam.

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?

See blood pressure requirements for stages of hypertension. The medical examiner may require clearance from your treating physician before you can be considered for certification.

What if I’m on blood pressure medication?

Taking blood pressure medications 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.

Also, it is very helpful, if you have 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 DOT examiner determine if you are medically fit to operate a commercial motor vehicle for the designated time frame of your DOT medical certificate.

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 examiner, and ask to have multiple BP’s taken. He should be taking 2-3 readings anyhow, especially if you say so up front.