with high blood pressure could lose their certification under new guidelines
that will appear on medical forms starting Sept. 30.
A DOT official previously told Land Line that the new blood pressure
levels were regulations. However, in an e-mail sent to the magazine recently,
that official said that the new levels are guidelines, not regulations.
they do not have the full force of regulation, the guidelines are contained on
the Federal Motor Carrier Safety Administration’s official examination form
that will be used to medically certify all drivers.
do have some latitude regarding drivers and blood pressure, FMCSA officials
said. The panel that developed the guidelines does acknowledge “blood
pressure's physiologic variations and measurement errors.”
the FMCSA indicated that if doctors do not use the new guidelines, they must
document that they used a medically accepted standard to show that the driver’s
blood pressure reading does not constitute a “current clinical diagnosis of high blood pressure.”
“The guidelines are to help the medical
examiner make that determination,” Bill MacLeod, director of communications at
the FMCSA, said in a written statement. “We strongly encourage medical
examiners to use them. They were developed, published and distributed for that
medical examiners choose not to use the guidelines, it is reasonable to expect
them to document some other best practice guidance or data to support their
how the new guidelines stack up:
with a blood pressure less than 140/90 can be medically certified.
- Truckers whose blood pressure
runs between 140/90 and 159/99 – called Stage 1 – can get a one-year certification,
but they must have a DOT certification exam each year thereafter, and
should have a blood pressure of less than 140/90. If their blood pressure
is more than 140/90 but less than 160/100, their certification may be
extended one time for three months.
with blood pressure readings between 160/100 and 179/109 – defined as
Stage 2 – will be certified for only three months, and must seek help from
their doctors to lower the reading. If drivers seek treatment and bring
their blood pressure reading back below 140/90, they can get a one-year
certification, but again must be re-certified every year thereafter.
drivers whose blood pressure is above 180/110 will be medically
disqualified. At that level, called Stage 3, drivers must seek treatment
and bring their blood pressure down to 140/90 or less to receive a
six-month certification, but then must seek re-certification every six
new guidelines, which were spelled out in a report by the FMCSA’s
Cardiovascular Medical Advisory Panel, were adopted in October 2002. The final
rule that placed them on the medical examination form was not published until
Sept. 30, 2003. Doctors can still use the old forms – which are still posted on
the agency’s Web site – until Sept. 30, 2004.
that date, the agency will require use of the new forms.
actual regulations are unchanged. That rule allows a driver to be certified if “the driver has no current clinical diagnosis of high blood pressure likely to
interfere with his/her ability to operate a motor vehicle safely.”
according to Donna Ryun with OOIDA’s Communications Department, even before the
new guidelines were published, the agency’s blood pressure rule was backed up
by a specific set of guidelines.
previous guidelines, which were contained in a listing of Medical Advisory
Criteria in an addendum to the regulations, said any driver with blood pressure
of 160/90 or less would be certified.
with blood pressure between 160/90 and 180/104 were given a three-month certification
and were required to be certified annually. Those above 180/104 were not
certified – not even temporarily – until they lowered their blood pressure to
that level or less.
FMCSA officials said the new guidelines
were based on the most recent blood pressure
guidelines produced by the Joint National Committee on Prevention, Detection,
Evaluation and Treatment of High Blood Pressure.
MacLeod said those figures “are recommended by the
accepted leaders in cardiovascular disease, including the National Institutes
of Health, the American Heart Association and the American College of
guidelines obviously represents the best meeting of the minds of the experts,
but with the recognition that there may be other solutions,” he said.
According to the American Heart Association, a blood
pressure of less than 120/80 is considered normal for adults. Any reading that
is above 140/90 is considered high.
The heart association literature says that even a blood
pressure reading between 120/80 and 139/89 is considered “prehypertension.” The
heart association recommends that people who have a reading in that range
should make changes in their lifestyle to bring the reading down.
--by Mark H. Reddig, associate editor
Mark Reddig can be reached at firstname.lastname@example.org.