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High blood pressure

High blood pressure (hypertension)

What it is

Hypertension means the pressure of blood pushing on your blood vessel walls stays too high.

VA's code numbers for this: 7101

What the examiner will do

Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.

  • Usually a VA or contract doctor, NP, or PA. Often 15-30 minutes.
  • They take your blood pressure, often 3 times. They ask when you were diagnosed, what medicine you take, and whether it affects your heart, kidneys, or eyes.
  • They look in your records for readings on at least 3 different days.

Tests, in plain words

Top number (systolic)
The pressure when your heart beats. In '150/95,' it's 150.
Bottom number (diastolic)
The pressure when your heart rests between beats. In '150/95,' it's 95. Most VA levels use this number.
'Predominantly'
Most of the time - more than half your readings, not one bad day.
Note (1) - the 3-day rule (this is law)
VA requires high blood pressure to be confirmed by readings taken 2 or more times on at least 3 different days. 'Hypertension' means the bottom number is mostly 90 or higher. 'Isolated systolic hypertension' means the top number is mostly 160 or higher with a bottom number under 90.

The examiner fills out a form called a DBQ. You can read it ahead of time: Hypertension DBQ (opens VA's site).

The rating levels, in plain words

VA picks the level that best matches how often and how badly the condition affects you.

  • 0%

    You have high blood pressure, but your readings don't reach the 10% numbers and you don't meet the medicine rule below.

    VA's exact words

    No 0% line is written for DC 7101; 38 CFR 4.31 assigns 0% when the lowest level is not met.

    Rule: 38 CFR 4.31; 38 CFR 4.104, DC 7101

  • 10%

    Most readings have a bottom number of 100 or more, OR a top number of 160 or more. OR: in the past, most of your bottom numbers were 100 or more, and now you need daily medicine to keep it down.

    VA's exact words

    Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control

    Rule: 38 CFR 4.104, DC 7101

  • 20%

    Most bottom numbers are 110 or more, OR most top numbers are 200 or more.

    VA's exact words

    Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more

    Rule: 38 CFR 4.104, DC 7101

  • 40%

    Most bottom numbers are 120 or more.

    VA's exact words

    Diastolic pressure predominantly 120 or more

    Rule: 38 CFR 4.104, DC 7101

  • 60%

    Most bottom numbers are 130 or more.

    VA's exact words

    Diastolic pressure predominantly 130 or more

    Rule: 38 CFR 4.104, DC 7101

What to track before your exam

What to write down: Blood pressure readings, medicine, and old records from before you started medicine.

How: Use a home arm cuff that fits your arm (not a wrist cuff). For 14 days, take 2 readings each morning and 2 each evening. Sit quietly for 5 minutes first. Feet flat, arm resting at heart level. No coffee, smoking, or exercise for 30 minutes before. Write every reading - don't skip high or low ones. Bring the cuff to a doctor visit once to check it's accurate. Also gather old records (service records, early doctor visits) showing readings before you started medicine - this matters for the 10% medicine rule.

Your log: what to write each time

  1. Date
  2. Time
  3. Reading 1 (top/bottom)
  4. Reading 2 (top/bottom)
  5. Arm used
  6. Took BP medicine today? time?
  7. Notes (headache, dizzy, missed dose, stress)

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.

Tell the examiner

Honest exam rules

  • Tell the whole truth. Don't add to it. Don't shrink it.
  • Describe a normal day AND your worst days. Say how often the worst days happen.
  • Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
  • It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
  • Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
  • If something hurts or makes you worse during the exam, say so right then.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.
  • Take your medicine as usual on exam day. The goal is your real, normal readings.

Common mistakes

  • Relying on one high reading at the exam. VA needs readings on at least 3 different days.

    Where this comes from: 38 CFR 4.104, DC 7101, Note (1)

  • Missing the medicine minimum. If you take daily BP medicine, show old readings where the bottom number was mostly 100+. Without that history, you may get 0%.

    Where this comes from: 38 CFR 4.104, DC 7101 (10% minimum evaluation clause)

  • Not claiming heart or kidney problems caused by high blood pressure. They are rated separately.

    Where this comes from: 38 CFR 4.104, DC 7101, Note (3)

  • Hypertension from Agent Orange areas is presumptive since the PACT Act - don't assume you need to prove cause if you served in a listed place.

    Where this comes from: 38 U.S.C. 1116 (PACT Act sec. 404); 38 CFR 3.309(e) - verify your location/dates

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. When were you first told your blood pressure was high?
  2. What blood pressure medicines do you take, and how often?
  3. Did you take your readings twice in the morning and twice at night for 2 weeks?
  4. Do you have the old readings from before you started medicine?
  5. Has your doctor said high blood pressure hurt your heart, kidneys, or eyes?

Rule changes you may hear about

Today's rules (above) are what VA uses unless a change is final.

  • Cancelled, not in force

    On Feb 17, 2026, VA put out a quick rule that would have rated you with the help your medicine gives you (38 CFR 4.10). VA cancelled it 10 days later. The old wording is back. Court case Jones v. Shinseki, 26 Vet. App. 56 (2012) still says: if the rating rule doesn't mention medicine, VA can't lower your rating because medicine helps.

    Where it stands: Rescinded effective Feb 27, 2026. Not in force.

    91 FR 7118 (Feb 17, 2026), interim final rule; 91 FR 9712 (Feb 27, 2026), rescission. RIN 2900-AS49

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.