The Hypertension DBQ is driven by numbers. The rating hinges on your predominant diastolic and systolic readings over time and whether you require continuous medication. Get the actual BP values and medication history on the record and the tier follows. Rated under 38 CFR § 4.104, Diagnostic Code 7101.
What the examiner is filling out
The Hypertension DBQ asks the examiner to record:
- Current blood pressure readings — three readings on the day of exam.
- Predominant readings — the examiner must state the predominant diastolic and systolic levels over the past year or more.
- Medication history — continuous medication required for control, including names and dosages.
- History of diastolic pressure ≥100 — critical for the 10% minimum when readings are now controlled.
- Complications — heart, kidney, eye, or stroke damage (rated separately if present).
The DC 7101 schedule
Hypertension diagnosed but predominant readings do not meet the 10% thresholds AND continuous medication is not required for control. Note: the 10% minimum applies whenever continuous medication is required, regardless of current readings.
The most common rating. Even if current readings are controlled, a documented history of diastolic pressure predominantly 100 or more plus ongoing medication qualifies.
Higher readings required. One or two spikes do not establish predominance; the examiner looks at the overall pattern.
Severe range. Must be the predominant level across multiple readings.
Maximum schedular rating under DC 7101. Rare and requires consistent, documented severe elevation.
The phrases that map to each tier
Magic words for this tier
To establish the 10% minimum (history + medication):
- “My diastolic readings were predominantly 100 or higher before medication brought them down.”
- “I have taken [medication name] continuously since [year] to control my blood pressure.”
Magic words for this tier
To establish 20% and higher (predominant readings):
- “My diastolic pressure has been predominantly 110 or higher on multiple readings over the past year.”
- “My systolic pressure has been predominantly 200 or higher.”
- “Even on medication, my predominant diastolic remains 120.” (for 40%)
Best evidence: BP log and pharmacy records
A simple home blood pressure log with dates, times, and readings is the strongest evidence. Pair it with pharmacy refill records showing continuous medication and any treatment notes stating the predominant level. Lay statements from family can confirm symptoms like headaches or fatigue but cannot replace actual readings.
What NOT to say
What NOT to say
- “My blood pressure is fine now on meds.” (Ignores the history + continuous medication rule for 10%.)
- “I only check it once in a while.” (Fails to establish predominance.)
- “It spikes when I’m stressed.” (Without showing the overall predominant level.)
- “I don’t really take the medication every day.” (Undercuts continuous-medication requirement.)
Complications are rated separately
If hypertension has caused heart enlargement, kidney damage, or stroke residuals, those conditions receive their own ratings. Mention them to the examiner so they can be evaluated under the correct diagnostic codes.
Use this with the rest of the site
- ▸ Hypertension condition guide — the full rating schedule, evidence checklist, and tactical plays.
- ▸ C&P Exam Prep generator — builds a personalized checklist for your specific conditions.
- ▸ Claim Coach — walks you through the 10 steps including C&P prep at Step 7.
- ▸ Full C&P exam guide — the universal say/don’t-say rules that apply to every exam.
Educational content only. DBQ structures are public knowledge from M21-1 and archived sources; VA discontinued public DBQ distribution in 2020 but the rating criteria these forms map to remain in 38 CFR Part 4. Not legal or medical advice. Always consult a VA-accredited VSO or attorney for claim-specific guidance. CFR citations: 38 CFR § 4.104 Diagnostic Code 7101 (hypertensive vascular disease), § 4.104 (diseases of the arteries and veins), § 3.159(a)(2) (competent lay evidence)..