DOT Medical Information Newsletter

November 1, 2018

Hypertension

Why is Blood Pressure (Hypertension) testing important for your DOT exam? 
Because high blood pressure usually does not cause any symptoms! That is why it is called, “The Silent Killer.” Blood pressure refers to the pressure that blood applies to the inner walls of the arteries. Untreated high blood pressure increases the strain on the heart and arteries, causing them to stiffen, limiting blood flow to your organs. High blood pressure increases the risk of heart failure, heart attack (myocardial infarction), stroke, and kidney failure. 
What do blood pressure numbers mean?

Blood pressure = Systolic Pressure / Diastolic Pressure (eg 120/70)

The Systolic pressure is the pressure in the arteries produced when the heart contracts (at the time of a heart beat).

Diastolic pressure refers the pressure in the arteries during relaxation of the heart between heart beats.

What are “the numbers” drivers need to pass for a medical certification?

Answer: 140/90, but, “it depends”.

1.

If a driver has never been diagnosed with high blood pressure, they are eligible for a time limited card if they have Stage 1 ( one year card)

Stage 1:

BP 140-159 systolic and/or 90-99 diastolic; the driver may be certified for up to one year. The driver will need to follow up with PCP to treat their hypertension and may need to start blood pressure medications. When they return in one year they will be recertified as a driver with a diagnosis of hypertension. To obtain recertification their blood pressure now must be 140/90 or lower for a one- year card.

or Stage 2( 3 month card) Hypertension

Stage 2: BP160-179 systolic and/or 100-109 diastolic; the driver may be certified for a 3-month card. The driver will be instructed to return before the 3- month expiration date with a letter from their PCP stating the medications and doses prescribed, along with office records showing blood pressure is now under control at 140/90 or less. CMUC will recheck the driver’s blood pressure, and if it is 140/90 or less, will issue a card good for the balance of one year.

Stage 3 Hypertension

(Note Drivers are disqualified if : 180 systolic and/or 110 diastolic or greater)

When following up with a prior diagnosis of hypertension for a new medical card

1.

If a driver has already been diagnosed with high blood pressure the reading must be 140/90 or less. If it is above this level the driver may be certified for 3 months to give them time to see their PCP and get the blood pressure under better control. The driver will be instructed to return before the 3- month expiration date with a letter from their PCP stating the medications and doses prescribed, along with office records showing blood pressure is now under control at 140/90 or less. CMUC will recheck the driver’s blood pressure, and if it is 140/90 or less, will issue a card good for the balance of one year.

Note: CMUC will not charge for a full DOT physical at this 3 -month visit, rather there will be a 25$ administrative fee to review records, check BP and generate the new card.

Also note, drivers with a diagnosis of high blood pressure, and with a disqualifying blood pressure at their annual exam of BP 180 or greater systolic, and/or 110 or greater diastolic will qualify for a maximum of 6 months once blood pressure is controlled to 140/90 or less. They are no longer eligible for one year cards and will need a full DOT physical every 6 months.

HIGH BLOOD PRESSURE TREATMENT

Untreated hypertension can lead to a variety of complications, including heart disease and stroke. The risk of these complications increases as blood pressure rises above 110/75,which is still in the healthy range. Treating high blood pressure can reduce the risk of heart attack, stroke, and death. 
Lifestyle changes — Treatment of hypertension usually begins with lifestyle changes. Making these lifestyle changes involves little or no risk. Recommended changes often include:

●Reduce the amount of salt in the diet 
●Lose weight if overweight or obese 
●Avoid drinking too much alcohol 
●Stop smoking 
●Exercise at least 30 minutes per day most days of the week