Reference: 38 CFR 4.104

Hypertension: Rating Criteria

The published percentage tiers and what separates them

Percentage Guides

Understanding Your Percentage

Select a pathway to see what the published criteria ask about, what records may clarify it, and what should not be assumed.

0%

Highest listed pathway

Hypertension is diagnosed, but current readings are well-controlled and below compensable levels (derived from 38 CFR § 4.31).

What separates the next level: A 10% rating requires readings of 100/160 or higher, or a history of diastolic 100+ that requires continuous medication to control.

Review CFR criteria, examples, and evidence

Official CFR language: A 0-percent noncompensable evaluation is not explicitly scheduled under DC 7101 but is assigned when the condition exists but does not meet the 10-percent threshold.
What the published criteria say: Assigned when hypertension is documented, but blood pressure is well controlled (diastolic below 100, systolic below 160) and there is no history of severe diastolic hypertension (100 or more) that required continuous medication to reach current control.
Examples: Veteran has confirmed high blood pressure well controlled by lifestyle changes without medication.; Veteran takes blood pressure medication, but historical diastolic readings were never predominantly 100 or more before treatment began.
Medical evidence: Blood pressure log showing predominant readings below 160/100.; Treatment records showing no history of diastolic 100+ requiring continuous medication.
Functional impact examples: Condition is effectively managed with minimal to no impact on daily functioning or employment.
Common misconceptions: Misconception: "Taking any blood pressure medication means a 10 percent evaluation." DC 7101 lists 10 percent for "a history of diastolic pressure predominantly 100 or more who requires continuous medication for control."
Related topics: Minimum evaluation rule
Source context

10%

Highest listed pathway

Diastolic pressure is 100 to 109, or systolic is 160 to 199, OR blood pressure is well-controlled now but required continuous medication after a history of diastolic pressure 100 or more.

What separates the next level: A 20% rating requires higher diastolic readings (110-119) or very high systolic readings (200+).

Review CFR criteria, examples, and evidence

Official CFR language: 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.
What the published criteria say: Assigned for moderate hypertension where the bottom number is 100-109 or the top number is 160-199. It is also the minimum assigned if past diastolic readings were 100+ and you now must take continuous medication to keep it controlled.
Examples: Recent readings over several days show blood pressure averaging 165/95.; Current readings are normal (120/80), but medical records confirm past readings of 140/105 and continuous daily medication is prescribed to maintain control.
Medical evidence: Blood pressure logs with predominant diastolic readings 100-109.; Blood pressure logs with predominant systolic readings 160-199.; Historical medical records showing diastolic 100+ and current pharmacy records showing continuous antihypertensive medication.
Functional impact examples: Requires daily adherence to medication and regular medical monitoring, with potential minor side effects from medication.
Common misconceptions: A single high reading of 160/100 warrants a 10% rating. (Readings must be predominant, taken two or more times on at least three different days.)
Related topics: Minimum evaluation rule; Isolated systolic hypertension
Source context

20%

Highest listed pathway

Diastolic pressure is 110 to 119, or systolic is 200 or higher.

What separates the next level: A 40% rating requires even higher diastolic readings (120-129). Systolic pressure alone cannot rate higher than 20%.

Review CFR criteria, examples, and evidence

Official CFR language: Diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more.
What the published criteria say: Assigned for moderately severe hypertension where predominant readings show a diastolic of 110-119, or extreme isolated systolic hypertension of 200 or higher.
Examples: Readings consistently show 170/115 despite treatment.; Readings consistently show 210/85 (isolated systolic hypertension).
Medical evidence: Confirmed medical readings of diastolic pressure predominantly 110-119.; Confirmed medical readings of systolic pressure predominantly 200 or more.
Functional impact examples: Increased risk of complications requiring aggressive medication management, frequent clinic visits, and possible limitations on strenuous physical exertion.
Common misconceptions: Misconception: "A systolic pressure of 220 alone reaches 40 percent." DC 7101 lists systolic predominantly 200 or more at the 20 percent level; the 40 percent level lists diastolic predominantly 120 or more.
Related topics: Isolated systolic hypertension
Source context

40%

Highest listed pathway

Diastolic pressure is 120 to 129.

What separates the next level: A 60% rating requires extremely severe diastolic readings of 130 or more.

Review CFR criteria, examples, and evidence

Official CFR language: Diastolic pressure predominantly 120 or more.
What the published criteria say: Assigned for severe hypertension where predominant diastolic readings are between 120 and 129.
Examples: Multiple readings across several days confirm blood pressure averages 180/125.
Medical evidence: Medical records confirming predominant diastolic blood pressure of 120 to 129 over multiple days.
Functional impact examples: Severe limitations on physical exertion, high risk for cardiovascular events, and likely experiencing side effects from multiple aggressive medications.
Common misconceptions: The 40% rating can be reached by combining a high systolic with a moderately high diastolic. (Only the predominant diastolic reading of 120 or more triggers this evaluation.)
Related topics: Confirmed Readings
Source context

60%

Highest listed pathway

Diastolic pressure is predominantly 130 or higher. (Excludes cases where hypertension is caused by aortic insufficiency or hyperthyroidism, per Note 2 causation exception).

What separates the next level: This is the highest rating available for hypertension itself under DC 7101.

Review CFR criteria, examples, and evidence

Official CFR language: Diastolic pressure predominantly 130 or more.
What the published criteria say: The maximum schedular evaluation for hypertension, assigned for extremely dangerous blood pressure levels where the bottom number is 130 or higher.
Examples: Medical records confirm an average blood pressure of 190/135 over multiple days.
Medical evidence: Clinical records showing predominant diastolic readings of 130 or greater over multiple assessment days.
Functional impact examples: Critical health risk requiring immediate and ongoing aggressive medical intervention, severely limiting all occupational and physical activities.
Common misconceptions: Misconception: "One high reading of 210/130 means 60 percent." DC 7101 lists 60 percent for "Diastolic pressure predominantly 130 or more"; Note (1) says readings "must be confirmed by readings taken two or more times on at least three different days."
Related topics: Confirmed Readings
Source context

NEXT DIRECTIVE // PUT THIS GUIDANCE INTO ACTION

What would you like to do next?

Compare Your Medical Records

Test your symptoms and evidence against published 38 CFR criteria.

Start Assessment

Add to Your Claim Summary

Track this condition and calculate your whole-person combined rating.

Open Claims Binder

Calculate Combined Rating

See how multiple disability ratings combine under 38 CFR §4.25.

Calculate VA Math

NextEvidence & DBQWhat documentation clarifies the criteria

Keep going

Compare a percentage level and combined-rating math, or review evidence context.

VA Math & Combined Ratings

Understand the whole-person method, final rounding, and bilateral limits, then calculate how percentages combine.

Open VA Math guide

Evidence Center

Understand common evidence categories and what they can clarify without treating them as a checklist.

Open Evidence Center