Hypertension (high blood pressure)

Hypertension means high blood pressure. The VA rates it under its cardiovascular rules in 38 CFR 4.104, using Diagnostic Code 7101, called "hypertensive vascular disease (hypertension and isolated systolic hypertension)." Under the rules, hypertension generally means the diastolic (bottom number) is predominantly 90 or more, and isolated systolic hypertension means the systolic (top number) is predominantly 160 or more with a diastolic under 90. The VA also requires that the high readings be confirmed by readings taken two or more times on at least three different days, and it looks at your pattern of readings over time (the word "predominantly"), not a single visit.

The percentage rating is driven by your blood pressure numbers and whether you need daily medication. The VA's schedule assigns 10% when diastolic pressure is predominantly 100 or more, or systolic is predominantly 160 or more, or as the minimum rating for someone with a history of diastolic pressure predominantly 100 or more who needs continuous medication to control it. It assigns 20% for diastolic predominantly 110 or more (or systolic predominantly 200 or more), 40% for diastolic predominantly 120 or more, and 60% for diastolic predominantly 130 or more, which is the highest level on this code. Because the code itself accounts for medication, being controlled by daily pills does not by itself bar a 10% minimum when there is the required history.

There are pathways that can ease the "nexus" (link-to-service) burden. As a chronic cardiovascular-renal disease, hypertension can be presumptively service-connected if it appears to a compensable (at least 10%) degree within one year of qualifying service, under 38 CFR 3.307 and 3.309(a). Separately, the 2022 PACT Act added hypertension as a disease associated with exposure to certain herbicide agents such as Agent Orange, so veterans with qualifying herbicide-exposure service may be considered under the herbicide presumption rather than having to prove a direct medical link. Note that hypertension is treated separately from heart disease and is not itself counted as "ischemic heart disease" under the VA's rules.

This is general educational information about how the VA's rules work, not legal advice or a VA decision about your individual claim.