HYPERTENSION 2002 Cardiovascular Conference Report Recommendation Tables, Page 55 PHYSIOLOGY/ DIAGNOSIS CERTIFICATION RE-CERTIFICATION FUNCTIONAL Yes, if asymptomatic. Essential Hypertension Evaluate for other clinical Rarely disqualifying CVD including alone. TOD†; Presence of TOD, CVD or diabetes may affect therapy selected. Stage 1 Usually asymptomatic; Yes Annual (140-159/90-99 mm Hg) Low risk for near-term Rarely disqualifying BP <140/90 at annual incapacitating event. alone. exam; If not, but <160/100, certification extended one time for 3 months. Stage 2 Low risk for incapacitating Yes event; risk increased in One time certification for (160-179/100-109 mm Hg) presence of TOD; 3 months. Indication for pharmacologic therapy. Yes, at recheck if: Annual BP <140/90mmHg Certify BP <140/90. for 1 year from date of initial exam. Stage 3 (>180/110 High risk for acute No mm Hg hypertension-related Immediately disqualifying; event. Yes, at recheck if: Every 6 months; BP <140/90 mm Hg; BP <140/90. Treatment is well tolerated. Certify for 6 months from date of initial exam. Secondary Hypertension Evaluation warranted if Based on above stages. Annual persistently hypertensive Yes if: BP <140/90 on maximal or near- Stage 1 or maximal doses of 2-3 nonhypertensive. pharmacologic agents; At least 3 months after May be amenable to surgical correction. surgical/specific therapy. TOD Target Organ Damage Heart Failure, Stroke or Transient Ischemic Attack, Peripheral † – – Artery Disease, Retinopathy, Left Ventricular Hypertrophy, Nephropathy. Examiner may disqualify a driver if TOD significantly impairs work capacity. Driver should have no excess sedation or driver’s orthostatic change in BP.
HYPERTENSION 2002 Cardiovascular Conference Report Recommendation Tables, Page 55 DIAGNOSIS PHYSIOLOGY/ FUNCTIONAL CERTIFICATION RE-CERTIFICATION Essential Hypertension Evaluate for other clinical CVD including TOD†; Presence of TOD, CVD or diabetes may affect therapy selected. Yes, if asymptomatic. Rarely disqualifying alone. Stage 1 (140-159/90-99 mm Hg) Usually asymptomatic; Low risk for near-term incapacitating event. Yes Rarely disqualifying alone. Annual BP <140/90 at annual exam; If not, but <160/100, certification extended one time for 3 months. Stage 2 (160-179/100-109 mm Hg) Low risk for incapacitating event; risk increased in presence of TOD; Indication for pharmacologic therapy. Yes One time certification for 3 months. Yes, at recheck if: BP <140/90mmHg Certify for 1 year from date of initial exam. Annual BP <140/90. Stage 3 (>180/110 mm Hg High risk for acute hypertension-related event. No Immediately disqualifying; Yes, at recheck if: BP <140/90 mm Hg; Treatment is well tolerated. Certify for 6 months from date of initial exam. Every 6 months; BP <140/90. Secondary Hypertension Evaluation warranted if persistently hypertensive on maximal or near- maximal doses of 2-3 pharmacologic agents; May be amenable to surgical/specific therapy. Based on above stages. Yes if: Stage 1 or nonhypertensive. At least 3 months after surgical correction. Annual BP <140/90 † TOD – Target Organ Damage – Heart Failure, Stroke or Transient Ischemic Attack, Peripheral Artery Disease, Retinopathy, Left Ventricular Hypertrophy, Nephropathy. Examiner may disqualify a driver if TOD significantly impairs driver’s work capacity. Driver should have no excess sedation or orthostatic change in BP.
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