DOT physical blood pressure rules
Rules checked against the eCFR and FMCSA guidance on November 11, 2026 · Not medical advice
Below 140/90, you can be certified for the full 2 years. Higher readings usually mean a shorter certificate, not an automatic fail. The cutoff for being disqualified on the spot, under FMCSA guidance, is a reading over 180/110.
The rule
The regulation itself is short: a driver must have "no current clinical diagnosis of high blood pressure likely to interfere with his/her ability to operate a commercial motor vehicle safely."[1] The specific numbers come from FMCSA guidance, which examiners use but aren't legally bound by.[2]
FMCSA's blood pressure stages
| Reading | Stage | Typical certification (FMCSA guidance) |
|---|---|---|
| Under 140/90 | Normal for this purpose | Up to 2 years |
| 140–159 / 90–99 | Stage 1 | 1 year |
| 160–179 / 100–109 | Stage 2 | One-time 3-month certificate. If you're under 140/90 within those 3 months, you can get a 1-year certificate. |
| Over 180/110 | Stage 3 | Disqualified. Once under 140/90, you can be certified at 6-month intervals. |
Source: FMCSA's hypertension stages guidance.[3] The stages apply to systolic (top) or diastolic (bottom) numbers.
Other points from FMCSA guidance
- One high reading isn't the final word. An elevated reading should be confirmed with at least two more measurements.[2]
- On blood pressure medication? FMCSA guidance says drivers treated for hypertension should be certified at least once a year.[3]
- Stage 1 at renewal: at later yearly exams the reading should be 140/90 or lower. If it's still above 140/90 but below 160/100, the examiner may give a one-time 3-month certificate.[2]
If your blood pressure has been high, talk to your own doctor before the exam, and bring your medication list. See what to bring.
Sources
- 49 CFR 391.41(b)(6) (eCFR)
- FMCSA Medical Examiner's Handbook, 2024 edition, section 4.6 (PDF)
- FMCSA, Effect on driver certification of hypertension stages (FAQ)
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Find a DOT physicalThis guide summarizes federal rules for interstate commercial drivers. It isn't medical or legal advice, and your medical examiner makes the final decision. Disclaimer.