The DOT Blood Pressure Playbook

Your medical card is the truck. Under 49 CFR 391.41, a systolic reading of 140 costs you a two-year card. 160 costs you three months. 180 costs you the run. Fifteen minutes in a chair decides your next two years.

The tiers, in plain English

• Under 140/90 — two-year card. The goal.
• 140–159 / 90–99 — one-year card. On probation.
• 160–179 / 100–109 — three-month card. Emergency mode.
• 180+ / 110+ — disqualified until controlled.

Seven days out

This is the window where behavior actually moves the number. Don't wait for the morning of.

• Cut sodium to under 2,000 mg/day. Jerky, ramen, pizza, deli meats, hot dogs — off the table.
• Water: a gallon a day. Dehydration spikes BP.
• Walk 20 minutes every fuel stop. Movement is medicine.
• Sleep 7+ hours in the sleeper. Under-sleep drives systolic 5-8 points.

48 hours out

• Zero alcohol. Not one beer.
• Cut caffeine to one cup a day. Ease off — sudden withdrawal spikes too.
• Grilled chicken, eggs, beans, rice, fruit. Nothing packaged.
• Walk twice the normal.

The morning of

• Water. No coffee. No energy drinks.
• Empty your bladder before they cuff you.
• Sit five minutes with feet flat on the floor.
• Feet on the floor, back supported, arm at heart level — this alone is worth 5-10 points.
• If the first read is high, ask for a second. It's your right.

What quietly runs it up

• Energy drinks (even one, morning of).
• Compression from a full bladder.
• The 20-minute rush from the lot to the sign-in desk.
• A cigarette in the parking lot 10 minutes before.
• Untreated sleep apnea (see: CPAP tracker in the app).

The long game

One clean week gets you the card. A clean quarter keeps you off medication. Track your morning reads, log your meals, walk the fuel stops. FreightFit vaults the med card and counts you down. Everything else is you.