High Blood Pressure: Commercial Driver Risk?

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High Blood Pressure: How Does This Affect Your DOT Medical Card?

One of the most frequent concerns we hear from commercial drivers regarding the DOT physical exam, is about high blood pressure.

Here is the excerpt from FCMSA Rules and Regulations Part 391.41(b)(6) regarding blood pressure:

“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 the ability to operate a commercial motor vehicle safely.”

Here are the medical guidelines according to the Federal Motor Carrier Safety Regulations (FMCSRs). Note that employers are allowed to impose more stringent CDL requirements.

Normal: Medically certified to drive for a two-year period

Normal – Corresponds to a BP of 90 – 119 systolic and /or a BP of 60 – 79 diastolic.

PreHypertension – Corresponds to a BP of 120 – 139 systolic and /or a BP of 80 – 89 diastolic.

A driver with a blood pressure of less than 140 systolic and 90 diastolic, is qualified and may get their DOT medical card to drive for a two-year period.

Stage 1 Hypertension: Medically certified to drive for a one-year period

Corresponds to a BP of 140 – 159 systolic and /or a BP of 90-99 diastolic.

A driver with a blood pressure in this range is at low risk for hypertension-related acute incapacitation and may get their DOT medical card to drive for a one-year period. A DOT physical exam should be done annually thereafter and should be at or less than 140/90. If less than 160/100, certification may be extended one time for three months.

Stage 2 Hypertension: One-time medical certification of three months

Corresponds to a BP of 160-179 systolic and/or a BP of 100-109 diastolic.

The driver is given a one-time DOT medical card of three months to reduce his or her blood pressure to less than or equal to 140/90.

A driver with a blood pressure in this range is a candidate for antihypertensive drug therapy. Provided treatment is well tolerated and the driver demonstrates a BP value of 140/90 or less, they may get their medical card for one year from the date of the initial exam. The driver should do a DOT physical exam annually thereafter.

Stage 3 Hypertension: Disqualified

Corresponds to a BP at or greater than 180 systolic and / or 110 diastolic.

A driver with a blood pressure in this range is considered a high risk for an acute BP-related event, and is disqualified.

The driver may not be qualified for a DOT medical card, 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 (redo their DOT physical exam every 6 months) thereafter if at recheck BP is equal to or less than 140/90.

Bottom Line For Commercial Drivers:
Your Blood Pressure Needs To Be BELOW 140/90.

How Is Blood Pressure Measured?

Blood pressure is represented by two numbers. The first and higher of the two is a measure of systolic pressure, or the pressure in the arteries when the heart beats and fills them with blood. The second number measures diastolic pressure, or the pressure in the arteries when the heart rests between beats. This pressure is measured in millimeters of mercury pressure (mmHg). Kind of like pounds per square inch on a tire gauge.

When you get your DOT physical exam, know what your blood pressure numbers mean.

  • Normal blood pressure should be around 110/70.
  • The average American has a blood pressure of 120/80.
  • If your blood pressure is between 120/80 and 140/90 you’re at risk for Hypertension.
  • 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.
  • Stage 1 Hypertension is considered present when blood pressure is at 140/90.
  • Stage 2 Hypertension is considered present when blood pressure is at 160/100.

Hypertension Is A ‘Silent’ Disease That Can Be Deadly

Beginning at a systolic pressure of 115 mmHg and diastolic pressure of 75 mmHg, cardiovascular disease risk doubles for each increment of 20/10 mmHg.

One of the most dangerous aspects of hypertension is that you may not know that you have it. There are generally no high blood pressure symptoms, so you usually don’t feel it. In fact, nearly one-third of people who have hypertension don’t know it.

The only way to find out if you have high blood pressure is to get your blood pressure checked on a regular basis. This is especially important if you have other medical conditions, are overweight, or have a family history of high blood pressure. Stop by Chiro Stop, at Sapp Bros. in Salt Lake City, and we’ll check your blood pressure for free.

High blood pressure symptoms that may occur include:

  • Severe headache
  • Pounding in your chest, neck, or ears
  • Shortness of breath
  • Irregular heartbeat
  • Nosebleed
  • Tiredness
  • Confusion
  • Vision changes
  • Swelling or edema (fluid buildup in the tissues)
  • Blood in your urine
Without treatment, hypertension can lead to blood vessel damage, heart attack or heart failure, stroke, kidney failure, and eye problems. Even the early stages of hypertension are known to increase the likelihood of damage in these areas, so if you have prehypertension, now is the time to address some lifestyle changes to reduce blood pressure to a normal range.

The #1 Secret To Reduce Blood Pressure

Everything about the human body is designed to move. The heart is just one of the muscles that moves blood around the body, and the heart depends on movement of the rest of the body to help it move blood around.  In other words, when you move your body you help your heart do its job.
As a commercial driver, your job is getting stuff from point A to point B as quickly as possible.  So you sit for hours on end with no movement.  This forces your heart to do all the work, to pump all the blood, for all of your body.  Something it was never designed to do.
So what’s the big secret to reduce blood pressure and stay out of hypertension?


Movement improves blood flow and helps to reduce blood pressure.

Move any way you can, any time you can!

  • Be conscious of sitting still for hours while you’re driving. Find ways to make even small movements in your feet, legs, hands, arms, shoulders and neck. The secret is in moving frequently.
  • Find ways to be active outside the truck. Ten minute activity periods, four or five times a day will go a long way to reduce blood pressure and maintain your DOT medical card at two year intervals.
    • Some drivers have a dog, which is a great reason to get out of the truck and walk for a few minutes.
    • When loading or unloading seems to be taking too long, take that time to move, stretch, and walk.
    • Park at the far end of the rest stop, and walk the long way around, to get into the building.
    • Don’t always eat at the truck stop. Walk to a nearby restaurant to eat. Walk to a nearby grocery store and buy some healthy food to eat on the road.
    • Step in and out of your truck 10 times after stopping for a meal. Or walk around your truck 10 times. Every extra step helps!
    • Walk around the parking lot, up and down the rows, and find the nicest looking customized truck.
  • Regular physical activity is one of the best things you can do for your heart. A healthy heart helps keep blood pressure low. Regular physical activity also helps control your weight and reduce stress. Any regular exercise like walking or biking, even 15 minutes a day will do wonders for your health.

10 Lifestyle Modifications To Reduce Blood Pressure Naturally

  1. Eat a Wide Variety of Natural Foods. Variety means fruits, vegetables, mushrooms, nuts, grains, seeds, meat, fish, eggs, milk, honey. Eat food made from ingredients that you can recognize in their natural state.  Tip: Highly processed foods, even though they come in thousands of different varieties of forms and packaging, do not contain a wide variety of food. In fact, most processed food consist of a concoction of a few ingredients derived from corn, soy, and wheat, and a bunch of chemical additives.
  2. Take Vitamins – Many vitamins have been shown to reduce hypertension but vitamins C, E, B5, B6 and folic acid, which is also a B vitamin have been the most effective. Apple cider vinegar includes vitamins C, A, E, B1, B2 and B6, in addition to potassium, magnesium, copper and many other helpful nutrients. We suggest mixing two tablespoons of apple cider vinegar with 8 ounces of water and a bit of honey to make up for the taste!
  3. Increase Calcium – This can be done by consuming low-fat dairy products or taking calcium supplements.
  4. Increase Potassium – This can be done easily by consuming foods such as cauliflower, cabbage, oranges, grapefruit, melons, bananas, and other fruits and vegetables.
  5. Increase Magnesium – Soy, beans, wheat germ, rice, nuts and bananas are a good source of magnesium.
  6. Reduce Sodium – Keep in mind that reducing sodium intake involves more than not using a salt shaker, but also checking for the sodium content  in processed and prepared foods.  Rather than common table salt  which is sodium chloride, use a natural mineral salt.
  7. Take Garlic – Garlic supplements work just as well as fresh garlic.
  8. Drink Water – Drink 50% of your body weight in ounces of water daily, e.g. if you weigh 200 lbs, drink 100 oz of water daily.
  9. Discontinuing Tobacco Use – Smoking can cause plaque and hardening of the artery walls.
  10. Manage Stress – Every time you stress out, your blood pressure jumps up. If stress is a permanent part of your life it can constantly keep your blood pressure high. Relaxation techniques, deep breathing, and physical movement are all good ways to de-stress. Restful sleep also reduces stress and lowers blood pressure.

Bonus: Lose some of those extra pounds – If you do much of the above, and you reduce processed carbohydrates in your diet, these extra pounds should come off naturally.

These lifestyle modifications are highly effective to reduce blood pressure naturally, although medication is still necessary for many patients with moderate or severe hypertension to bring their blood pressure down to a safe level.

Blood Pressure Medications

It is very important, if you have hypertension, that you take the medications prescribed to you. See our tips to prepare for your DOT physical. If you have side effects, your health care provider can substitute a different medication.

There are many classes of medications for treating hypertension, together called antihypertensives, which — by varying means — act by lowering blood pressure.

Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. Each added drug may reduce the systolic blood pressure by 5–10 mmHg, so often multiple drugs are often necessary to achieve blood pressure control.

The aim of treatment should be to reduce blood pressure to lower than 140/90 mmHg for most patients, and lower than that in certain cases such as diabetes or kidney disease, where levels below 120/80 mmHg are recommended.

The goal of treatment is to reduce blood pressure so that you have a lower risk of complications. After the blood pressure goal is reached, you should continue to see your doctor every three to six months, depending on whether other diseases are present.

Check your blood pressure regularly! If you’re driving through Utah, stop by and visit us at Chiro Stop, in the Sapp Bros. truck stop in Salt Lake City. We’ll check your blood pressure for free.

Your Livelihood, Your Lifestyle, Your Life!

You may be concerned about your blood pressure because you’re concerned about your livelihood – that your CDL is at risk.

If that’s the case, then you should be concerned about your health too – that your life is at risk. Hypertension is an indication of more serious health issues ahead.

Commercial driving is a challenging lifestyle. Will it control the way you live, or will you manage the way you live, within its constraints? By knowing what the problems are, you can take action to make the outcome different. Begin with small changes. Treat the Lifestyle Modification List like a buffet. Choose one or two ideas from the list and try them out. If they fit for you, keep doing them, and then add another. In just a few weeks you’ll feel better, and in just a few months you’ll have won that bonus – dropping some of those extra pounds.

Make your next DOT physical exam easy. Keep your eye on the goal: a healthy blood pressure range. Your improved lifestyle will serve your livelihood and your life.

Leave a comment


  1. Trucker Doc

     /  January 21, 2017

    You lose your valid medical card until you get you BP under control.
    If you live in a state that kills your cdl, then you would need to check with your local drivers license department to determine what happen after you lose your medical certificate.

  2. john m

     /  January 19, 2017

    what happens if my blood pressure is still a couple points high after the three months extention on med card,1 do i lose my license with any options to retest to keep my cdl’s? 2 or am i jst out of luck for having cdl’s? wht are my options ? thanks

  3. Trucker Doc

     /  December 14, 2016

    Not a medical question, so we can’t answer it.
    This is an employment / legal question. Maybe you can work out something with your employer.

  4. Curt

     /  December 13, 2016

    I failed my DOT physical because of high blood pressure. I was terminated the same day. Does the company have the right to do that? Short term disability or medical leave wasn’t offered.

  5. Trucker Doc

     /  October 24, 2016

    Check with the drivers license department on this one. Most states want a valid medical card to go with a valid CDL, but given your circumstances they will probably cut a bit of slack, but confirm don’t assume.

  6. Hector

     /  October 23, 2016

    Will DOT put CDL on hold until I get my blood pressure under control in Texas? If I go to Dmv my M card expires 10/27/2016 4 to 5 days and I just found out that I have high blood pressure it’s not enough time to get under control so I can pass the test.

  7. Trucker Doc

     /  November 25, 2015

    You don’t have to return to the same doctor, but you will probably have to go through the full DOT examination at another facility.
    If you are not presently on blood pressure medication you should receive a limited medical card until you have it under control. If the blood pressure is the only issue, then you should receive a 3 month card to get your condition under control. But you can go to any CME on the registry.

  8. Howard sankey

     /  November 24, 2015

    I had a physical done November 6th the doctor said my blood pressure was 142 over 110 she then gave me a 3 months certificate to drive 5 days later my company said I was disqualified at that time I was 1100 miles away from where I had my physical. I was told I couldn’t drive my truck I would have to catch the bus home or rent a car go to a doctor get on medication get my blood pressure down and then go back to the doctor who disqualified me must the same doctor that disqualified me requalified me or for me to go to the same doctors office because I did that another doctor saw me both work at the same location all my records are there at this location and they said I cannot drive because of the same doctor who made the mess who made the mistake did not redo my physical is this true please help

  9. Brian

     /  November 18, 2015

    I have somewhat larger arms from lifting weights. I have heard this can affect BP readings. Can’t get my arm into those machines at Walmart.

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