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.
Qualification explanation
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
Taking any blood pressure medication automatically qualifies for a 10% rating. (A 10% rating based on medication requires that past diastolic readings were predominantly 100 or more before the medication controlled it.)
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.
Qualification explanation
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.
Qualification explanation
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
A systolic pressure of 220 can qualify for a 40% rating. (Systolic pressure alone caps at a 20% evaluation; higher evaluations require high diastolic pressure.)
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.
Qualification explanation
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.
Qualification explanation
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
A single hypertensive crisis reading of 210/130 automatically guarantees a 60% rating. (The rating requires readings to be predominant over at least three different days.)
Related topics
Confirmed Readings
Source context

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