As a certified medical examiner, blood pressure is the number one issue I see with drivers. Not a day goes by I don't have a driver with elevated blood pressure come into my office. Most of the time the drivers are surprised by the new finding, many did not have high blood pressure at their last physical. Occasionally, I will have a driver that indicates he or she was at their M.D. a couple of days ago and did not have high blood pressure.
Let us explore common reasons for elevated blood pressure in drivers. The number one cause of high blood pressure is being overweight. The problem of obesity among drivers is a major issue. The lack of availability of good food on the road, coupled with hours of driving and lack of exercise makes a perfect storm for weight gain. Weight has an enormous impact on blood pressure. Weight loss of just a few pounds can begin to decrease blood pressure without medications. Losing 10-20 pounds can have dramatic blood pressure lowering effects. Cutting just 500 calories per day can help you lose 1-2 pounds per week in a healthy, sustainable way.
Nutritional supplementation has been shown to lower blood pressure in patients that have mild levels of hypertension. Cellular energy production is important to the cardiovascular system because the heart and blood vessels are in a constant state of breakdown and repair. CoQ10 is a very important supplement and is involved with cellular energy production. CoQ10 has been shown to lower blood pressure an average of 17.8 points when taking 60mg twice per day.
Fish oil may sound bad but it is really good for you. Fish oils contain omega-3 fatty acids and are great at helping lower blood pressure naturally. Omega-3 fatty acids also help decrease inflammation and that will ward off conditions like cardiovascular disease. Since the vast majority of people in the United States have a diet very low in fish, it is recommended everyone supplement with an omega-3 fatty acid. I generally recommend 1,000mg per day of omega-3 fatty acids.
Calcium and magnesium supplementation is also very important. Studies have shown, supplementation with 1,000mg per day of calcium for women and 500mg per day for men coupled with 370mg per day of magnesium will lower blood pressure slightly.
The next biggest culprit of elevated blood pressure is smoking. The topic of smoking is something I address with drivers when they come into the office. Not only can smoking elevate your blood pressure, it will lead to other health issues like stroke, emphysema, cancer, gum disease and more.
Many drivers who smoke will have elevated blood pressure right after smoking. Of course I would encourage any driver to quit. In the short term, refrain from smoking before your exam. It could make the difference between a 1 or 2 year certificate or even disqualification.
As a side note, if you are trying to quit smoking, taking Chantix automatically disqualifies the driver. According to the FMCSA no driver is allowed to drive while taking Chantix due to the psychological risks associated with the drug.
If you go to the doctor and he says you have high blood pressure, what is next? Well, you have a some choices depending on what your readings are. Keep in mind, when I make a recommendation in this article, they are generalized and should not be taken as advice for your specific situation. Please consult your physician.
If a driver has pre-hypertension (121/81 to 139/89) they will still be qualified to drive and will get a 2 year certificate. At this stage of pre-hypertension, lifestyle changes are sufficient to keep you in a healthy blood pressure range. Simply exercising, and some weight loss will work wonders. Supplementation with CoQ10, Omega-3 fatty acids, calcium and magnesium will also help control the blood pressure in this stage.
When the pressure increases to 140/90 to 159/99 the driver is considered to have Stage 1 hypertension. This is the point where things are getting serious and should be considered a red flag for the driver to change their lifestyle immediately. The driver will still be eligible to have a medical certificate for 1 year but during this time the driver must get control over their blood pressure. Weight loss, smoking cessation and a good diet are key at this stage. I would recommend getting medication to help control the pressure to prevent damage to the cardiovascular system while the driver works on the root cause of the hypertension. If after 1 year the driver still does not have the hypertension under control (139/89 or below) either by lifestyle modifications or medications, they will be eligible for a one time 3 month certificate. If after 3 months, they are still not 139/89 or lower, the driver is disqualified from driving.
In stage 2 hypertension, 160/100 to 179/109, the driver will receive a one time 3 month medical certificate. When a driver has hypertension of this level, medication is essential to prevent damage to the cardiovascular system. At this point, the driver must change their lifestyle. Having sustained pressures in this range can lead to stroke, kidney damage, erectile dysfunction or death.
Stage 3 hypertension180/110 or above is an extremely serious condition that should be regarded as a medical emergency. Drivers with blood pressure in this range are disqualified from driving and are generally sent directly to the nearest ER. Blood pressure in this range will shorten your life significantly. Any driver that has had this level of blood pressure in the past can only have a 6 month medical certificate from that point forward. If you have blood pressure at this level you are at very high risk of stoke or sudden death.
To conclude, your blood pressure is literally a life and death safety issue for not only you but other people on the roadway. With just a little lifestyle change you can make significant impact on your overall health. Take care of yourself so you can stay safe on the job.
Dr. Richard L. Rodgers II D.C., CME
FMCSA Certified Medical Examiner