Secondary Hypertension

The prevalence of secondary hypertension in the general population is estimated at between 5% and 20%. You should obtain information that assesses the underlying cause, the effectiveness of treatment, and any side effects that may interfere with driving.

Examples of primary conditions that may lead to secondary hypertension include pheochromocytoma, primary aldosteronism, renovascular disease, and unilateral renal parenchymal disease. Some of these conditions may be amenable to surgical intervention.

Waiting period

Minimum — 3 months post-surgical correction

NOTE: If more than one waiting period applies (because of multiple cardiac conditions or other comorbid diseases), examine the driver for certification after the completion of the longest waiting period.

Decision

Maximum certification period — 1 year post-surgical correction

NOTE: Determine nonsurgically repaired secondary hypertension using the essential hypertension guidelines.

Recommend to certify if:

The driver has blood pressure (BP) that is less than or equal to 140/90.

Recommend not to certify if:

As the medical examiner, you believe that the nature and severity of the medical condition of the driver endangers the health and safety of the driver and the public.

Monitoring/Testing

You may on a case-by-case basis obtain additional tests and/or consultation to adequately assess driver medical fitness for duty.

Follow-up

The driver should have an annual medical examination.

Hypertension Recommendation Table (PDF)