Putting on the Pressure

The revised blood pressure guidelines are based on a report, “Cardiovascular Advisory Panel Guidelines for the Medical Examination of Commercial Motor Vehicle Drivers.” You can view the document by visiting this site and searching for “cardiovascular guidelines.”

The suggested criteria for judging acceptable blood pressure for your medical examination have gotten tougher. A medical examiner can use the new guidelines now, though they will not
appear on the medical form until its Sept. 30 revision.

Even after Sept. 30, an examiner is free to use other guidelines to determine whether your blood pressure makes you unfit to drive. However, if the new criteria are not applied, “the medical examiner should document other best practice guidelines and/or data to support his or her decision,” says Dave Longo, spokesman for the Federal Motor Carrier Safety Administration.

Instead of the current two stages, the new guidelines address three stages of hypertension that can trigger disqualifications:

STAGE 1. This covers 140/90 mmHG through 159/99 mmHG, which is a 20-point change in the systolic pressure from the current threshold of 160. If you test at this level, you can be certified for only one year. After that, if your readings stay within that scope, you will be issued a one-time, three-month recertification, during which the hypertension must be treated so that it remains at or below 140/90 mmHG.

STAGE 2. If your blood pressure is 160/100 mmHG to 179/109 mmHG, you will be issued a one-time, three-month certification. Once the hypertension is under control – at 140/90 mmHG or less – you will be issued a one-year certification from the date of the initial exam, and thereafter be recertified on an annual basis as long as blood pressure remains at or below 140/90 mmHG.

STAGE 3. If your blood pressure is above 180/110 mmHG, you will be disqualified until you are treated and your blood pressure remains at 140/90 mmHG or less. Then you will be given a six-month certification from the date of the initial examination and recertified every six months.

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Most of the 50 million-plus U.S. adults who have high blood pressure don’t control it well enough to prevent complications, according to the Mayo Clinic. High blood pressure can lead to heart attack, heart failure, kidney failure, stroke or premature death.

Because hypertension has few early symptoms, many people aren’t aware they have it. If your medical exam provides the first warning of a problem, be grateful for the notice – and take steps to get it under control.

Blood pressure experts say losing weight, exercising, eating less salt, stopping smoking and drinking less alcohol can go a long way toward decreasing blood pressure, lowering heart-disease risk, and making blood pressure drugs work better.

People with high blood pressure, in addition to lowering salt intake, should follow the National Heart, Lung, and Blood Institute DASH (Dietary Approaches to Stop Hypertension) eating plan:

  • 7-8 servings of grains and grain products
    per day
  • 4-5 servings of vegetables per day
  • 4-5 servings of fruit
    per day
  • 2-3 servings of low-fat or nonfat dairy foods per day
  • 2 servings, at most, of meat per day
  • 4-5 servings of nuts, seeds, and legumes per week
  • 2-3 servings of fats and oils per day
  • 5 servings of low-fat treats per week

For more information about DASH, visit the “heart/vascular” section under this site.