Use of the term in reports or in VA guidance will most Note: “hypertension” often be used as a synonym for any type of hypertensive vascular disease. Subject to the exception below, service connection (SC) for hypertensive b. Blood Pressure vascular disease requires current blood pressure readings (obtained during the Readings claim period) which meet the regulatory definition of either Required for SC hypertension, or isolated systolic hypertension. Current readings meeting the regulatory standards for the Exception: definitions above if are not required the competent evidence shows a diagnosis of hypertension or isolated systolic hypertension, currently controlled by (or asymptomatic with) medication, and a past competent diagnosis was made in service based on manifestation of blood pressure readings to a compensable degree within the presumptive period as provided in and , or secondary to a service-connected (SC) disability. Notes: When SC is established based on the exception above (where current readings do not meet the regulatory definitions), the disability percentage will be either 0 percent or 10 percent, depending on whether or not the predominant diastolic pressure was 100 or more before symptoms were controlled with medication as provided in . A disability first clearly diagnosed after service can be SC under when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. For more information on References: the concept of competent evidence and policies on evaluating the competency of evidence, see M21-1, Part III, Subpart iv, 5. the multiple blood pressure readings confirmation requirement see, M21-1, Part III, Subpart iv, 4.E.1.c considering a diagnosis of pre-hypertension, see M21-1, Part III, Subpart iv, 4.E.1.d, and considering predominant blood pressure readings in evaluation of hypertensive vascular disease, see M21-1, Part III, Subpart iv, 4.E.1.e. In addition to the definitional requirements for a diagnosis of hypertension or c. The Multiple Blood Pressure isolated systolic hypertension , Note 1 provides a second criterion that must Readings be met for a diagnosis to be acceptable.
Note: Use of the term “hypertension” in reports or in VA guidance will most often be used as a synonym for any type of hypertensive vascular disease. b. Blood Pressure Readings Required for SC Subject to the exception below, service connection (SC) for hypertensive vascular disease requires current blood pressure readings (obtained during the claim period) which meet the regulatory definition of either hypertension, or isolated systolic hypertension. Exception: Current readings meeting the regulatory standards for the definitions above are not required if the competent evidence shows a diagnosis of hypertension or isolated systolic hypertension, currently controlled by (or asymptomatic with) medication, and a past competent diagnosis was made in service based on manifestation of blood pressure readings to a compensable degree within the presumptive period as provided in and , or secondary to a service-connected (SC) disability. Notes: When SC is established based on the exception above (where current readings do not meet the regulatory definitions), the disability percentage will be either 0 percent or 10 percent, depending on whether or not the predominant diastolic pressure was 100 or more before symptoms were controlled with medication as provided in . A disability first clearly diagnosed after service can be SC under when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. References: For more information on the concept of competent evidence and policies on evaluating the competency of evidence, see M21-1, Part III, Subpart iv, 5. the multiple blood pressure readings confirmation requirement see, M21-1, Part III, Subpart iv, 4.E.1.c considering a diagnosis of pre-hypertension, see M21-1, Part III, Subpart iv, 4.E.1.d, and considering predominant blood pressure readings in evaluation of hypertensive vascular disease, see M21-1, Part III, Subpart iv, 4.E.1.e. c. The Multiple Blood Pressure Readings In addition to the definitional requirements for a diagnosis of hypertension or isolated systolic hypertension , Note 1 provides a second criterion that must be met for a diagnosis to be acceptable.