Stage 1 Hypertension

Stage 1 hypertension is usually asymptomatic, and blood pressure (BP) in this range is considered a low risk for hypertension-related acute incapacitation. However, all hypertensive drivers should be strongly encouraged to pursue consultation with a primary care provider to ensure appropriate therapy and healthcare education.

BP measurement greater than or equal to 140/90 and less than 160/100.

Waiting period

No recommended time frame

NOTE: The driver who is disqualified for the presence of high BP/uncontrolled hypertension should not be considered for recertification until the BP is stabilized at less than or equal to 140/90. Treatment should be well tolerated before considering certifying a driver with a history of stage 3 hypertension.

Decision

Maximum certification period — 1 year OR one time for 3 months

Recommend to certify for 1 year if:

It is the first examination at which the driver has BP equivalent to stage 1 hypertension and the driver:

• Has no history of hypertension.
• Does not use antihypertensive medication to control BP.

Recommend to certify one time for 3 months if:

The driver has:

• A 1-year certificate for untreated stage 1 hypertension.
• Not been prescribed antihypertensive medication to control high BP.

This applies to the recertification of the driver who has met the first examination 1-year certification parameters. Advise the driver that failure to lower BP to less than or equal to 140/90 will render the driver medically unqualified for continued certification.

The driver:

• Has a diagnosis of hypertension treated with medication.
• Tolerates treatment with no side effects that interfere with driving.

This applies to the driver with inadequately controlled BP. Advise the driver that failure to lower BP to less than or equal to 140/90 will render the driver medically unqualified for continued certification.

Recommend not to certify if:

The driver has:

• A one-time, 3-month certificate for elevated BP or hypertension and BP greater than 140/90.
• A history of stage 3 hypertension and BP greater than 140/90.
• BP greater than or equal to 180/110, regardless of any other considerations.

NOTE: "One-time" means you cannot issue consecutive 3-month certificates for BP greater than 140/90. It does not mean once in a lifetime.

Monitoring/Testing

The driver who is disqualified for stage 1 hypertension may be recertified for 1 year if BP is lowered to less than 140/90.

The driver who is disqualified for stage 3 hypertension may be recertified for 6 months if BP is lowered to less than 140/90 and medications are well tolerated.

Follow-up

The driver with elevated BP or hypertension should have at least an annual medical examination.

When certified for 3 months, the driver is to seek initiation or evaluation of drug therapy to lower BP to less than or equal to 140/90 to be recertified at follow-up examination.

Hypertension Recommendation Table (PDF)

When determining certification for the driver with high BP or hypertension, take into consideration current driver certification status, use of antihypertensive medication, and severity of hypertension prior to treatment.