DOT Physical blood pressure hacks

Picture of exam equipment including Sphygmomanometer, Reflex Hammer and Stethoscope

When scheduling and exam, your DOT Physical blood pressure is a very common concern. I am a Rocklin Chiropractor and certified member of the National Registry of Certified Medical Examiners and I am authorized to perform Commercial Driver Physical Exams for the DOT’s Federal Motor Carrier Safety Administration. If you are concerned about whether you will pass, then clearly you will also be concerned about the dot physical cost. I am probably the only exam provider that has REDUCED the fee for a DOT physical. I used to charge more, but I lowered my price to match a doctor that left the area to move out of state. So while the prices for everything else has gone up, the DOT physical cost has stayed the same – at least here in Rocklin. The local medical resources charge more than $100 (Kaiser charges more like $150!!). But my practice is focused in minimizing your cost (only $75) and maximizing your convenience with dedicated appointments with no waiting.

DOT Physical Blood Pressure

My profession is focused on helping patients and those drivers who come to me for DOT commercial driver fitness certification. I am not a rule maker. I am not a rule enforcer. In fact, I am required to follow my own set of rules just as drivers are. So, if I had my way, I would pass every driver, because ever driver would be fit to drive. But, unfortunately, that just isn’t the case and isn’t a realistic expectation since, like hypertension, many conditions develop without subjective symptoms. When you have high blood pressure, that can be a condition or just a symptom of a different primary condition. I have become quite familiar with the leading causes of disease in the population I treat and I can give drivers key insight as to how to meet certification requirements throughout their career. As a driver spends more years in his profession, he will get better and better at driving. But with years comes age and older drivers struggle with chronic conditions like high blood pressure. Since you aren’t always aware of rising blood pressure, this often takes drivers by surprise when they can’t meet the federal blood pressure fitness standard. While I can’t guarantee any health outcome, I can tell you with personal certainty that if you follow my advice you will get as low a blood pressure reading a possible. And more importantly, I am including critically important tips on what to do to not only get your blood pressure down, but dramatically improve your health and your ability to turn around any health challenges that have been holding you back – perhaps without even you being aware of it. So here we go with information that could literally change your life.

Now, whether you consider if fair or not, if you are a commercial driver, being fit is part of your job. I am a Chiropractor in Rocklin and in my office, I am interested in total body health and wellness. For this reason, I am one of those chiropractors who actually record blood pressure readings as a normal course of business whenever I am performing an exam. One of four non-discretionary elements of the DOT physical blood pressure is a critical part of every Federal Motor Carrier Safety Administration physical certification exam. Unless a driver meets the federal standards, he or she will not be able to maintain a license to drive a commercial vehicle. Suffice it to say that I see a LOT of elevated blood pressure readings (called “hypertension”) because, well… because I look for it. In the U.S. where 70% of the population is overweight or obese and where heart disease is the #1 leading cause of premature death, it should not be surprising that you will find hypertension if only you bother to look for it. It is certainly no coincidence that 65% of the U.S. population over 60 years of age has high blood pressure.

A blood pressure measurement includes an upper number (the systolic pressure which corresponds to the maximum artery pressure that occurs when the ventricles of the heart are contracting) and a lower number (the diastolic pressure which corresponds to the resting period between contractions). Any blood pressure measuring higher than 115 mm Hg systolic over 80 mm Hg diastolic is considered “above normal” in the general healthcare disciplines. When you look at the effect of an average 20 point rise in systolic pressure and/or a 10 point rise in diastolic pressure, studies show that the corresponding risk of a life threatening cardiac event doubles. DOUBLES! 100% increase!. That is huge. In addition, hypertension, while hard on the kidneys and other organ systems, is typically not a primary condition but is instead a result of other disease processes that are already damaging your health elsewhere in your body. So, yeah, blood pressure is a big deal. Especially since 50% of those with hypertension are not aware of it and go untreated in the U.S.

What can you do about it? In chiropractic, we know that blood pressure is affected by the level of stress you are under. One of the big benefits of chiropractic is the reduction of the sympathetic dominance (also known as the “fight, fright and flight” response) and the increased parasympathetic response (aka the “rest and digest” response). Is that enough to counter a pathologically elevated blood pressure? Probably not. A more sure way to lower blood pressure is to lose weight, right? Well, sure. But if it were that easy, heart disease and hypertension and a host of other diseases wouldn’t pose such a problem as they do in the U.S. The challenge is that if you are overweight, losing weight requires effort. And people often do not make the sustained lifestyle changes that would be needed to improve their health. I often counsel commercial drivers that if they have any concerns about their blood pressure, then they should plan ahead for their certification exams by walking 30 to 45 minutes per day, switching to decaffeinated coffee, drinking lots of water, decreasing the consumption of high fat and high sugar meals, avoiding alcohol and avoiding smoking for at least 3 weeks prior to their exam. This will allow them the best chance to demonstrate a blood pressure that will allow for driver certification (a blood pressure requirement which is actually higher than “normal”, since the FMCSA only requires drivers to demonstrate a blood pressure below 140/90 mm Hg).

I’m writing this today to share some research that has caused me to update my recommendations. As it turns out, diaphragmatic exercises, isometric exercises and stretches have been shown in research studies to reduce blood pressure significantly. I will provide references below, but if you want to lower your blood pressure for a commercial driver certification exam, you may want to include the following exercises along with the recommendations I have previously suggested during those 3 weeks prior to your exam:

  1. Train the diaphragm – Use a breathing trainer (available on Amazon for as little as $30) to exercise your diaphragm with inspiratory exercises, 30 inhales at a time, twice a day. The diaphragm’s whole job is to manage the pressure in y our chest to facilitate breathing. The heart and lungs are both integrally affected by thoracic (ie. “chest”) pressure changes that diaphragmatic function produces. In a small 2019 study, those doing these breathing exercises enjoyed a 10 mm Hg drop in systolic blood pressure while those that did not do the exercises had no change at all.
  2. Isometric exercise – Do isometric exercise (meaning contracting muscles without movement), such as something so simple as the daily squeezing of both fists for two minutes followed by a 3 minute rest and repeated 3 more times . You don’t even need to squeeze hard as the 1992 study that used this approach demonstrated a reduction in blood pressure with the participants only contracting 30% of their capacity. Several studies since the 1992 have demonstrated improvements of 12 to 15 mm Hg in blood pressure resulting from isometric exercise.
  3. Stretches – Perform stretches of the calves, quads and hamstring muscles. A 2020 study concluded that this causes a stretch of the arteries triggering remodeling of the inner lining of those arteries and improvement in their production of nitric oxide and better allowing them to normally relax, and significantly improving the participants’ blood pressure readings.

OK, so if you are a driver, you might be thinking, “Aha! That is how I can pass my physical without having to go on blood pressure medicine!”. Well, yes, this may be true. In fact, these studies all showed improvements similar to those resulting from pharmaceutical treatments. But consider what I have recommended in the past for the 3 weeks before your physical:

  1. Exercise (walking)
  2. Diet (reduce caffeine, reduce intake of dietary fats and sugars)
  3. Eliminate toxins (don’t drink alcohol or smoke – both known cancer causers, btw)

Now, add these items:

4. isometric contractions
5. breathing exercises
6. stretches

If after all of the hacks above, you are still registering high blood pressure, then you just need to check in with your primary medical doctor for help because there are many serious conditions that produce symptomatic high blood pressure and you need to rule them out because most of them are treatable (AND often reversible as I will share below). As I alluded to earlier, ignoring high blood pressure is a REALLY bad idea because it contributes to heart attacks and strokes. But beyond that, it can do real damage to your kidneys which don’t typically recover fully, once they are damaged and you do NOT want to spend the rest of your life on dialysis waiting for a kidney transplant. And the kidneys are not the only organ at risk. Conditions such as Obstructive Sleep Apnea elevate blood pressure as you spend every night in what is like a heart-racing marathon to deliver oxygen to your body while you keep pausing your breathing. This leads to heart damage as the heart gets overworked and like the kidney damage, the heart damage is largely irreversible.

I will close this with a revisit to my primary role. As a chiropractor, I am interested in NATURAL non-medical approaches to health. Even though I am doing medical exams for the DOT’s FMCSA, you can’t take the chiropractor out of the examiner. So I often send a courtesy email to drivers which includes links to a couple of very informative videos and to free resources on how to get started with a plant-based diet trial. It is part of what I do for no additional charge. I try really hard to make chiropractic care AND DOT Physical exam cost affordable – You will find it very difficult to find a better price for DOT exams than our $75 fee and I have patients who only pay $35 per month for chiropractic care.

If you are having challenges with impotence, prostate problems, indigestion, blood sugar issues, elevated blood pressure, high cholesterol, frequent constipation or diarrhea… then a 3 month trial on a plant-based diet is an EXTREMELY important step and is frankly a “No Brainer” in order to understand the REAL cost of your current lifestyle. I am confident that if you will just try it for 3 months, you can ONLY BENEFIT! There is NO DOWNSIDE here!!!

  • You will save money (no meat to buy)
  • You will lose weight (I lost about 10 pounds per month – eating until I was stuffed – for the first 3 months!)
  • You blood pressure and cholesterol will go down
  • Your blood sugar will improve
  • Your liver enzymes will improve
  • You will feel more energized and motivated to exercise
  • You will LOOK BETTER!
  • You will have less inflammation and pain!!!!
  • Your bowel movements will be effortless and more regular
  • Your libido will likely get a kick start, also!

Do you need more convincing? If you email me, I will happily send you an email with a link to a FANTASTIC scientifically based presentation on why and how a plant based diet addresses the 15 leading causes of death in the U.S.

So… what are you waiting for? Stop stressing about whether you will pass your DOT exam and start thriving instead. You will never look back!

References to studies regarding isometric exercise, stretches and breathing exercises on blood pressure:

  • Wiley RL, Dunn CL, Cox NH, et al. Isometric exercise training lowers resting blood pressure. Med Sci Sports Exerc 1992 Jul;24(7):749-54.
  • Bisconti AV, Cè E, Longo S, Venturelli M, Coratella G, Limonta E, Doria C, Rampichini S, Esposito F. Evidence for improved systemic and local vascular function after long-term passive static stretching training of the musculoskeletal system. J Physiol. 2020 Sep;598(17):3645-3666.
  • Craighead DH, Heinbockel TC, Freeberg KA, Rossman MJ, Jackman RA, Jankowski LR, Hamilton MN, Ziemba BP, Reisz JA, D’Alessandro A, Brewster LM, DeSouza CA, You Z, Chonchol M, Bailey EF, Seals DR. Time-Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above-Normal Blood Pressure. J Am Heart Assoc. 2021 Jul 6;10(13):e020980

Note: Content of this article was based on reporting by columnist Thomas Michaud, DC in October 2021 Dynamic Chiropractic

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