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Hypertension Guidelines Flashcards

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  1. Under FMCSA regulations, a commercial driver with a blood pressure reading of 160/100 mmHg at the time of examination should be:

    Answer: Certified for 1 year with follow-up required

    Stage 2 hypertension (160-179/100-109 mmHg) permits a one-time certification of up to 12 months, requiring treatment and follow-up to confirm BP control.

  2. A CME is examining a driver taking a thiazide diuretic for hypertension. Which side effect is most relevant to commercial driving safety?

    Answer: Hypokalemia causing muscle weakness or cramps

    Thiazide diuretics can cause hypokalemia leading to muscle weakness, cramps, and fatigue, all of which can impair a driver's ability to safely operate a commercial vehicle.

  3. Which blood pressure threshold constitutes Stage 3 (severe) hypertension requiring disqualification under FMCSA guidelines?

    Answer: ≥180 systolic or ≥110 diastolic

    Blood pressure of 180/110 mmHg or higher is Stage 3 hypertension and disqualifies a driver from certification until it is treated and confirmed below that threshold.

  4. A driver on beta-blocker therapy reports dizziness when standing quickly. This symptom most likely represents:

    Answer: Orthostatic hypotension

    Beta-blockers can reduce cardiac output and blunt compensatory reflexes, causing orthostatic hypotension with positional dizziness that may impair driving.

  5. When a driver's BP is confirmed at 179/109 mmHg after two separate readings, the FMCSA guidance recommends:

    Answer: One-time certificate up to 12 months with treatment initiated

    Stage 2 hypertension (160-179/100-109) allows a single 12-month certificate to allow time for treatment and BP reduction before re-evaluation.

  6. Which antihypertensive drug class is most associated with a chronic dry cough that could distract a commercial driver?

    Answer: ACE inhibitors

    ACE inhibitors cause a bradykinin-mediated dry cough in up to 20% of patients, which can be distracting and disruptive during driving.

  7. A CME documents a driver's BP as 138/88 mmHg on exam. Per FMCSA classification, this driver falls into which category?

    Answer: Normal — certify up to 2 years

    A BP below 140/90 mmHg is considered normal (or treated-controlled) under FMCSA guidelines, qualifying the driver for a standard 2-year medical certificate.