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Hypertension Guidelines Flashcards

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  1. A commercial driver presents for a recertification exam. His blood pressure is measured at 164/102 mmHg. He has a history of Stage 1 hypertension and has been on medication for the past year. According to FMCSA guidelines, what is the most appropriate action for the medical examiner to take?

    Answer: Issue a one-time 3-month certificate and advise him to follow up with his primary care provider.

    The driver's blood pressure falls into the Stage 2 hypertension range (160-179/100-109 mmHg). For a driver with Stage 2 hypertension, the examiner should issue a one-time, 3-month certificate to allow the driver to seek treatment to lower their blood pressure to 140/90 mmHg or less.

  2. A 52-year-old driver is found to have a blood pressure of 182/114 mmHg during his initial DOT physical exam. Which of the following is the correct determination?

    Answer: Disqualify the driver.

    A blood pressure reading at or above 180/110 mmHg is considered Stage 3 hypertension. According to FMCSA guidelines, a driver with Stage 3 hypertension must be medically disqualified. The driver cannot be certified, even for a short period, until their blood pressure is reduced to 140/90 mmHg or less and the treatment is well-tolerated.

  3. A driver was disqualified for Stage 3 hypertension. He returns to your office two months later, and his blood pressure is now 138/88 mmHg with treatment. What is the maximum certification period for which this driver is now eligible?

    Answer: 6 months

    After a driver has been disqualified for Stage 3 hypertension (BP ≥ 180/110 mmHg), once their blood pressure is reduced to 140/90 mmHg or less and treatment is well tolerated, they may be certified for a maximum of 6 months. Recertification is required every 6 months thereafter.

  4. A new applicant for a commercial driver's license has a blood pressure of 148/94 mmHg on their first examination. The driver is not on any antihypertensive medication. What is the appropriate certification period?

    Answer: 1 year

    This blood pressure reading (140-159/90-99 mmHg) is classified as Stage 1 hypertension. For a first-time finding of Stage 1 hypertension, the driver may be certified for a maximum of one year.

  5. Which of the following blood pressure readings allows for a 2-year medical certification, assuming the driver has no other disqualifying conditions and is not on any antihypertensive medication?

    Answer: 136/84 mmHg

    To qualify for a 2-year medical certificate, a driver must have a blood pressure reading of less than 140/90 mmHg and not be on medication for hypertension. A reading of 136/84 mmHg meets these criteria. The other readings are either at or above the 140/90 mmHg threshold.

  6. A driver with a history of treated hypertension presents for his annual recertification. His blood pressure is 152/96 mmHg. He was previously certified for one year. What is the appropriate next step for the medical examiner?

    Answer: Issue a one-time, 3-month certificate to allow for adjustment of his treatment.

    At a recertification exam for a driver with a history of hypertension, if the blood pressure is in the Stage 1 range (140-159/90-99 mmHg), the examiner can issue a one-time certificate for 3 months to allow the driver time to be evaluated and treated to bring their blood pressure back down to ≤ 140/90 mmHg.