DOT Physical Blood Pressure: New Requirements & Tips for Passing

The blood pressure requirements for DOT physicals can seem daunting. Here's what you need to know if you have high blood pressure.

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. 

Can You Pass the DOT Physical with High Blood Pressure? 

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. 

What is Considered Normal Blood Pressure for the DOT Physical?

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.

What is Considered High Blood Pressure for the DOT Physical?

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.

What is the Highest Blood Pressure for the DOT Physical?

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. 

What is the Blood Pressure Range for the DOT Physical?

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. 

Can you Pass the DOT Physical on Blood Pressure Medication?

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. 

What are the New 2023 DOT Physical Requirements for Blood Pressure?

The figures listed above are the current 2023 DOT physical requirements for blood pressure, though they may change to reflect the medical profession’s raised awareness of the problems hypertension can cause. 

Can You Fail a DOT Physical for High Blood Pressure?

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. 

How to Lower Your Blood Pressure to Pass the DOT Physical

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. 

1. Lose unnecessary pounds. Being overweight can cause all sorts of health issues and nearly always leads to increased blood pressure – even losing a little will help reduce your blood pressure as your heart won’t have to work so hard to pump blood around your body.  
2. Exercise regularly. Even as little as 20 minutes of purposeful walking every day can make a real difference, lowering your blood pressure by up to 8 mm Hg. Commercial drivers often don’t get time to get to the gym so walking can be important. Try parking at the back of the lot so you naturally walk a little further when stopping to eat or shop.  
3. Reduce sodium. Too much sodium will push up your blood pressure. Cut down on salt and where possible use low sodium salt. 
4. Eat healthily. That doesn’t mean just vegetables, lean protein is great too. It is so easy to get fast food but they tend to be loaded with sugar and salt. And cut out sugary drinks and go to the low-cal alternatives.  
5. Limit your alcohol. A little can be good for lowering your blood pressure but too much will raise it. By a little we are talking a small glass of beer or wine, so stay aware. 
6. Stop smoking. Apart from other health problems it can cause, smoking does increase your blood pressure for a period after you smoke. At the very least, don’t smoke before you take the DOT physical. 
7. Reduce stress. Learn to relax. Practice breathing exercises and avoid stress triggers. 
8. Buy a blood pressure monitor. They only cost a few dollars and allow you to monitor regularly what your blood pressure is and if it changes. 
9. Talk to your doctor about medication. This is a good idea even if you plan to make lifestyle changes, especially if your blood pressure is dangerously high. Your heart health is not a matter to be taken lightly, so take care of yourself!  

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. 

Quicker & Easier DOT Physical Exam Scheduling

Now that you know the DOT physical blood pressure requirements for 2023, 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 files once they pass their DOT physical exams. 

Get a FREE demo of the Foley DOT physical software today.

Links to Related Articles in This Series:

The DOT Physical: Everything You Need to Know 

DOT Physicals: Can Chiropractors and Other Doctors do DOT Physicals?

DOT Physicals: Vision Requirements for the Eye Exam      

DOT Physicals: Can You Pass with a High BMI or While Overweight? 

DOT Physicals: Can I Get a DOT Physical in Any State? 

DOT Physicals: Can You Pass with a Hernia? 

DOT Physicals: Will I Pass with Diabetes? 

DOT Physicals: Can I Pass With Sleep Apnea? 

DOT Physicals: What if I have a Medical Condition? 

DOT Physicals: Do They Include a Drug Test? 

How to Prepare for Your DOT Physical? 

DOT Physicals: What Happens When You Fail? 

Fail a DOT Physical? You Have a Right to a Second Opinion 

DOT Physicals: Understanding Medical Variances