Stage 2 Hypertension

Stage 2 hypertension is considered an absolute indication for antihypertensive drug therapy, and the driver should seek initiation or evaluation of therapy to lower blood pressure (BP). Effective BP management includes routine primary provider follow-up and periodic screens for the presence of target organ damage and clinical manifestations of cardiovascular disease.

BP measurement greater than or equal to 160/100 and less than 180/110.

Waiting period

No recommended time frame

NOTE: The driver who is disqualified for 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 — One time for 3 months

Recommend to certify if:

It is the first examination at which the driver has BP equivalent to stage 2 hypertension and the driver:

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

The driver:

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

NOTE: Advise the driver issued a one-time, 3-month certificate that:

• To qualify at follow-up, BP should be at or less than 140/90.
• If the driver at follow-up qualifies, a 1-year certificate will be issued from the date of the initial examination, not the expiration date of the one-time, 3-month certificate.
• If the driver fails to lower BP by the expiration date of the one-time, 3-month certificate, the driver will be disqualified until BP is at or less than 140/90 at examination.

Recommend not to certify if:

The driver has:

• A one-time, 3-month certificate for stage 2 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.

Monitoring/Testing

Provided treatment is well tolerated and the driver demonstrates BP of 140/90 or less, the driver may be certified for 1 year from the date of the initial examination.

Follow-up

The driver must follow-up on or before the one-time, 3-month certificate expiration date. If the driver has BP less than or equal to 140/90, the driver may be certified for 1 year.

NOTE: The elapsed time of the one-time, 3-month certificate is included in the annual certification interval; it is not an extension to the certification period. This means that you use the date on the one-time, 3-month certificate to calculate the medical certificate expiration date. Do not use the date of the follow-up examination at which the driver demonstrates adequate BP.

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.

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.