Hypertension VA Rating: Your Readings Decide It

Blood pressure has two numbers. The top one (systolic) is the pressure while your heart beats, and the bottom one (diastolic) is the pressure between beats. For VA purposes:

• Hypertension means the bottom number is predominantly 90 or higher.
• Isolated systolic hypertension means the top number is predominantly 160 or higher while the bottom stays under 90.

Either one has to be confirmed by readings taken two or more times on at least three different days. "Predominantly" is the word to remember, because the VA looks for the pattern across your records. A single 170/110 in an emergency room while you were in pain won't carry a claim alone. A run of clinic visits at 150/96 can.

When medication is doing its job, the bottom number rarely gets near 110. That's why the last clause of the 10% level matters so much. If your records show a history of diastolic readings predominantly 100 or more and you now need continuous medication to keep it down, 10% applies even when today's numbers look fine.

Finding that history is the real work. Check your service treatment records, your separation physical, and the early civilian visits where a doctor first prescribed medication. Readings from before that first prescription are the ones that prove the floor, so request old records if you need them. Without that history, controlled hypertension is often rated 0%.

The PACT Act, signed in August 2022, added high blood pressure to the VA's list of conditions presumed to come from Agent Orange and other herbicides. If you served in a qualifying place and time, you don't need a doctor to explain the link. You need a diagnosis, and the condition has to reach at least the 10% level.

The VA presumes herbicide exposure for service in these places and periods:

• Vietnam: January 9, 1962 to May 7, 1975, including inland waterways and the offshore waters covered by the Blue Water Navy rules
• Thailand: any U.S. or Royal Thai military base, January 9, 1962 to June 30, 1976
• Laos: December 1, 1965 to September 30, 1969
• Cambodia: Mimot or Krek in Kampong Cham Province, April 16 to 30, 1969
• Guam or American Samoa, or their territorial waters: January 9, 1962 to July 31, 1980
• Johnston Atoll, or a ship that called there: January 1, 1972 to September 30, 1977
• Korean DMZ, in or near it: September 1, 1967 to August 31, 1971

C-123 aircrews and maintainers, and anyone whose duties involved moving, testing or storing herbicides, can also qualify. If the VA turned down your hypertension before the PACT Act, the new presumption is a reason to file again. Our PACT Act guide covers the details.

Conditions that can drive blood pressure up

With a medical opinion, hypertension can be service connected as secondary to a condition that already is, such as sleep apnea, kidney disease or PTSD, or to medication taken for one, like long-term anti-inflammatory pain relievers or steroids.

Conditions high blood pressure can cause

Service-connected hypertension can in turn support claims for heart disease, kidney disease and stroke. The rating schedule says to rate hypertension separately from hypertensive heart disease and other heart conditions, so both can be paid. Some blood pressure drugs also contribute to erectile dysfunction, which brings special monthly compensation.

One limit: when high blood pressure comes from aortic valve insufficiency or an overactive thyroid, the VA rates it as part of that condition instead of on its own.