High blood pressure is the number one cause of failure to pass a DOT physical examination. In recent months, Lakeside’s healthcare providers have noticed a concerning trend of individuals presenting with high blood pressure. Some of these were identified to be caused from recent ingestion of “power” or “energy” drinks. Others patterns have been identified with those who ingest natural supplements for body building. These “natural” drinks and supplements often contain stimulants that affect heart rate and blood pressure increases.

Lakeside’s nurse practitioner, Jim Troxler, has prepared blood pressure education material that will aid in educating your workers on how they can better control their blood pressure. It is our hope that your workers will be well prepared to pass their DOT physical examination when they arrive at Lakeside.

As always, Lakeside’s goal is to support a safe, healthy, and productive workforce.
Please feel free to share this document with your workers.
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HIGH BLOOD PRESSURE
By: Jim Troxler, MPH, MSN, ARNP
WHY SHOULD YOU CARE?
HOW TO GET YOUR BEST POSSIBLE READING FOR YOUR PHYSICAL EXAMINATION

Hypertension (high blood pressure) is known as the silent killer because most people with high blood pressure cannot feel any symptoms even when the pressures are dangerously high.

One adult in three in the US has high blood pressure. High blood pressure is dangerous because it damages blood vessels, which leads to heart and kidney disease, aneurysms, blindness, heart failure, amputations, and strokes. All of these health problems can affect your ability to work, and may lead to loss of employment and even death.

According the the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, the following categories describe blood pressures:

Blood Pressure type [Systolic - top number] Diastolic - bottom number
Normal - [Less than 120] and Less than 80
Prehypertension - [120-139] or 80-90
Stage 1 - [140-159] or 90-99
Stage 2 - [160 or higher] or 100 or higher

All blood pressures above 120/80 raise your risk for the health issues and death as listed above.

HOW YOU CAN CONTROL YOUR LIFESTYLE TO LOWER RISK FOR HIGH BLOOD PRESSURE.

Certain lifestyle habits increase your risk for high blood pressure:
- Being overweight
- Too much salt in the diet
- Drinking too much alcohol
- Smoking
- Not getting enough potassium in the diet
- Not getting enough physical activity
- Not getting enough sleep
- Not having regular checks of blood pressure
- Not taking blood pressure medicine as prescribed
- Eating and drinking foods and drinks high in stimulants

Have your blood pressure checked regularly. Even if you don’t have high blood pressure, by checking your blood pressure regularly, you can identify signs of increasing blood pressure and initiate early intervention and control. This may save your life.

Reference: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP

BLOOD PRESSURE CONTROL AND YOUR DOT PHYSICAL

One of the major reasons for failure to obtain a DOT card after the physical examination is high blood pressure. There are several things the driver can do to insure their blood is as low as it can be for their physical.

For the long term:
- Exercise at a moderate intensity at least 30 minutes a day
- Maintain a healthy weight
- Quit smoking.
- Have no more than one alcohol drink for women or two alcoholic drinks for men in 24 hours
- Follow a diet that is moderate in salt, sugars, and fats
- Manage stress through whatever means works for you; personal, social, or professional means

For the short term:
- Get a good night sleep the night before the physical
- Take blood pressure medicine at least 2 hours before the exam
- Avoid stimulants that are found in coffee, tea, colas, Mountain Dew, and energy/power drinks
- Avoid “natural” health herbs or drinks that contain stimulants
- Empty your bladder 30 minutes before your blood pressure is taken
- Sit quietly 5 minutes before your blood pressure is taken

The Federal Motor Carrier Safety Regulations (49 CFR 391.41) publishes guidelines that specify criteria regarding certain medical conditions and qualifications for driving. A DOT medical examiner’s certificate is typically valid for up to 24 months. However, the medical examiner may also issue a medical examiner's certificate for less than 24 months when it is desirable to monitor a condition, such as high blood pressure.

If your blood pressure greater than 140/90, you may not qualify for a full term DOT card. The DOT medical examiner may issue a provisional card that will allow for a period of time for you to see your healthcare provider for evaluation and/or treatment to better control your blood pressure.

References:
• http://www.fmcsa.dot.gov/rules-regulations/topics/medical/aboutdotexam.htm
• http://www.fmcsa.dot.gov/documents/safetyprograms/medical-Report.pdf

Lakeside’s healthcare professionals possess expert knowledge of DOT regulations and requirements for physical qualifications. Contact a Lakeside clinic to schedule your DOT physical examination.