The Playbook › Condition guides
High blood pressure is one of the most common conditions among veterans, and one of the most commonly rated at the lowest level. VA rates it almost entirely on the numbers: what your readings predominantly are. Most veterans whose blood pressure is controlled by daily medication land at 10%.
The rating is modest, but hypertension matters for what it can lead to and for the three different ways it can be service connected.
The short version
- Hypertension is rated under Diagnostic Code 7101 at 10%, 20%, 40%, or 60%.
- The rating follows your predominant readings, mainly the diastolic (bottom) number.
- A history of diastolic 100 or more, now controlled by continuous medication, supports the minimum 10%.
- It is presumptive for Agent Orange exposure, and for any veteran if it appears within a year of discharge.
- It is rated separately from heart disease.
On this page
The rating criteria
| Rating | Criteria |
|---|---|
| 10% | Diastolic pressure predominantly 100 or more; or systolic pressure predominantly 160 or more; or a history of diastolic pressure predominantly 100 or more that requires continuous medication for control |
| 20% | Diastolic pressure predominantly 110 or more; or systolic pressure predominantly 200 or more |
| 40% | Diastolic pressure predominantly 120 or more |
| 60% | Diastolic pressure predominantly 130 or more |
“Predominantly” means what your readings usually show, not your single highest reading.
How VA confirms the diagnosis
For rating purposes, hypertension must be confirmed by readings taken two or more times on at least three different days. VA defines hypertension as diastolic pressure predominantly 90 or greater, and isolated systolic hypertension as systolic predominantly 160 or greater with diastolic below 90.
The medication rule
Many veterans assume that because medication keeps their readings normal, they cannot be rated. That is not right. If your records show a history of diastolic readings predominantly 100 or more before treatment, and you now need continuous medication, you qualify for the minimum 10%.
The key is the history. If your diastolic readings were never predominantly 100 or more, medication alone does not support a compensable rating, and VA may assign 0%.
Three ways to get service connected
1. Direct
Elevated readings in your service treatment records, a diagnosis in service, or readings at your separation exam. Go through your records and list every blood pressure reading with its date. A pattern of elevated readings in service, even without a diagnosis, is useful evidence.
2. Presumptive
- Within one year of discharge. Hypertension is on VA’s list of chronic diseases. If it appeared to a degree of 10% or more within a year of leaving service, it is presumed service connected.
- Agent Orange. The PACT Act added hypertension as a presumptive condition for veterans exposed to herbicides. If you served in Vietnam, Thailand, the Korean DMZ, or another qualifying location, you do not need to prove the cause. See Agent Orange presumptive conditions.
3. Secondary
Hypertension is often claimed as caused or worsened by another service-connected condition:
| Primary condition | Connection |
|---|---|
| PTSD and other mental health conditions | Chronic stress response |
| Sleep apnea | Repeated drops in oxygen overnight |
| Kidney disease | The kidneys regulate blood pressure |
| Diabetes | Often occurs together; may be linked through kidney damage |
| Medications | Some anti-inflammatories and other drugs raise blood pressure |
Each of these needs a medical opinion. See secondary conditions and nexus letters.
What hypertension can lead to
A hypertension rating is a foundation for other claims, each rated separately:
- Heart disease, including hypertensive heart disease
- Stroke and its lasting effects
- Kidney disease
- Eye conditions caused by high blood pressure
- Erectile dysfunction, including from blood pressure medication, which can qualify for Special Monthly Compensation
The regulation says hypertension is evaluated separately from hypertensive heart disease and other heart disease, so a veteran can hold both ratings.
Evidence that helps
- Blood pressure readings over time, from service and since
- A home blood pressure log. VA will rely mainly on clinical readings, but a log supports the pattern.
- Pharmacy records showing continuous medication and when it started
- Records from before you started medication, showing how high your readings were
- For secondary claims, a medical opinion with reasoning
At the C&P exam
The examiner takes several readings and reviews your history. Take your medication as you normally would. Bring your medication list and any home log. If your readings were much higher before treatment, point the examiner to those records, because that history is what supports the 10% minimum.
Common reasons for denial or a 0% rating
- No readings in service and no diagnosis within a year of discharge, with no medical opinion linking it
- Current readings controlled by medication, with no documented history of diastolic 100 or more
- A secondary claim filed with no medical opinion
If you were denied before 2022 and you have qualifying herbicide exposure, file again. Hypertension became presumptive for Agent Orange in August 2022. See what to do after a denial.
Free printable checklist. Everything to gather before you file, what to bring to your C&P exam, and what to check in your decision, on two pages.
Last reviewed October 2026. This guide is general educational information, not legal or medical advice, and this site is not affiliated with the Department of Veterans Affairs. Rules and rates change. Confirm details on VA.gov or with an accredited representative. See our disclaimer and editorial policy.