High blood pressure, also known as hypertension, is an extremely common health problem in the US. Almost 50% of adults, that’s over 100 million people, have blood pressure exceeding 130 mm Hg for their systolic blood pressure or 80 mm Hg for their diastolic blood pressure, or are on medication for their hypertension.
Even more surprising is that 76% of this group are not aware or in control of their condition. Besides the need to get high blood pressure under control to maintain good health well into your twilight years, as a commercial truck driver, you need to keep your blood pressure under control to pass the DOT physical every 1–2 years.
To help you understand what is required of you in terms of blood pressure to pass the DOT physical, we’ve answered all the most common questions below and outlined some tips that can help you lower your blood pressure quickly before your upcoming exam. If you’re looking for an overview of DOT Physicals, you’ll find that here.
Blood pressure is measured with two figures. The systolic blood pressure (higher figure) is the force at which your heart pumps blood around the body while the diastolic pressure (lower figure) is the pressure in your blood vessels between heartbeats. Both are measured in millimeters of mercury – mm Hg.
You can pass your physical with above-normal blood pressure, but if your blood pressure is too high, you will not pass.
If your blood pressure is normal, you will pass with no conditions.
If your blood pressure is high, between 140-159 systolic and/or 90-99 mm Hg diastolic, it is described as “Stage 1” high blood pressure. If your blood pressure is in this range, you will pass but you will be required to take the DOT physical annually.
If your blood pressure is between 160-179 systolic and/or 100-109 diastolic it is considered “Stage 2” high blood pressure, and you will only be granted a 3-month certificate in which you will be asked to take action to reduce your blood pressure down to 140/90 or better.
If your blood pressure is higher than 180 systolic and 110 diastolic, you are considered “Stage 3” high blood pressure, are high risk, and you will not pass the DOT physical. At Stage 3, no certification will be granted. To continue driving a commercial motor vehicle, you must reduce your blood pressure to or below 140/90. Should they do so they will be approved to drive for six months before they have to get another physical. The biannual checks will continue provided the figures are maintained.
Normal blood pressure is defined as anything below 120/80 mm Hg – you’ll often hear this as 120-over-80. Elevated blood pressure for the DOT physical is defined as 120-139 systolic and/or 80-89 diastolic, and blood pressure within this range will also not flag any problems during your exam.
The blood pressure limits set anything above 140 systolic and/or 90 diastolic as high blood pressure. If you are below these numbers no action is taken. Anything above and some form of restriction will be imposed.
At Stage 1, you will be required to take the DOT physical annually rather than the normal biannual. At Stage 2 you will be allowed to drive but have to reduce your blood pressure to Stage 1 levels within three months. At Stage 3, you will have to stop driving a truck until your blood pressure is under control.
The highest blood pressure you can have as a commercial truck driver and still pass, though not without restriction, is 179/109, though it’s likely your Medical Examiner will have some concerns.
If your blood pressure is over 140/90, it’s a good idea to start tackling your high blood pressure, both for your well-being and so you do not encounter future problems passing the DOT physical. Treatment usually includes both medication and lifestyle changes but results are often swift.
The blood pressure requirements are simple – anything below 140/90 and you pass. Anything above, and some action is necessary.
Blood pressure regulations for the DOT physical help to make sure that truck drivers remain safe. Hypertension is an overlooked risk factor for everyone and catching it early and controlling it is key for a healthy life.
The blood pressure guidelines from the American Heart Association, along with other health authorities, lowered the Stage 1 figures to 130/80 showing how seriously high blood pressure should be taken.
There is no problem if you routinely take prescribed medication for high blood pressure. Taking such medication is common and allows blood pressure to return to safe levels offering an improved long-term outlook.
The figures listed above are the current 2025 DOT physical requirements for blood pressure, though they may change to reflect the medical profession’s raised awareness of the problems hypertension can cause.
Once your blood pressure rises to more than 140/90 you will have to take action to continue to get certification on a long-term basis. Once it rises above 180/110 you will fail the physical examination, but if you can go away and reduce your blood pressure levels below 140/90 you can reapply.
If your blood pressure is high, the best thing to do is start taking action to lower your blood pressure for your well-being so you can continue doing your job as a commercial truck driver.
There are several ways to lower your blood pressure to allow you to pass the DOT physical, though many are not quick fixes.
Hypertension is a potential killer. We should all be more aware of high blood pressure and the DOT physical is a good place to start. If the examination shows inflated figures, use it as an opportunity to start making positive changes for a better, healthier future.
Now that you know the DOT physical blood pressure requirements for 2025, it's time to schedule your DOT physical.
Scheduling DOT physicals for drivers is easier than ever for owner-operators and fleet managers. Foley's automated DOT physicals software automatically sends reminders whenever drivers need an exam and auto-orders them for you. Plus, the drivers' new medical certificates are uploaded to their digital driver files once they pass their DOT physical exams.
Get a FREE demo of the Foley DOT physical software today.
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