What blood pressure reading do you need to pass?
For a full 2-year DOT medical card, your blood pressure should be below 140/90. You can still pass with higher readings, but the card may be shorter. A reading of 180/110 or above is a fail until treated.
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The three tier system
| Reading | Result | Medical Certificate Length |
|---|---|---|
| Below 140/90 | Pass | 2 years |
| 140–159 / 90–99 | Pass (Stage 1) | 1 year |
| 160–179 / 100–109 | Pass (Stage 2) | 3 months to stabilise |
| 180/110 or above | Fail | Treatment required before retest |
What happens if you fail blood pressure at a DOT physical
The examiner documents the reading and explains what must happen before certification. Most drivers see their doctor, adjust medication, bring the pressure down, and retest.
Can you take medication for blood pressure and still pass?
Yes. Blood pressure medication is common and allowed. The key is that your blood pressure is controlled and the medication does not cause side effects that make driving unsafe.
Tips for the day of your exam
- Avoid caffeine and nicotine before the exam.
- Take prescribed medication on schedule.
- Rest before you arrive.
- Arrive early so you are not rushing.
- Ask for a second reading after sitting quietly.
How to appeal a blood pressure failure
You can be retested after treatment. Bring proof from your treating doctor if medication was changed. If you believe the reading was wrong, you may also visit another FMCSA-certified examiner.