★ Cardiovascular
Hypertension VA Rating
38 CFR § 4.104, Diagnostic Code 7101
Overview
Hypertension is commonly secondary to PTSD, sleep apnea, or diabetes.
Even controlled hypertension qualifies for 10% if there's a documented history requiring continuous medication.
In Depth
Hypertension is rated under 38 CFR § 4.104, DC 7101 based on diastolic and systolic readings: 10% (diastolic 100+ or systolic 160+, or continuous medication required for control with prior diastolic 100+), 20% (diastolic 110+ or systolic 200+), 40% (diastolic 120+), and 60% (diastolic 130+).
The 'continuous medication' clause matters — a veteran whose blood pressure is well controlled now but who required medication and had documented diastolic 100+ before treatment can qualify for the 10% rating.
Hypertension is a frequent secondary claim to PTSD (chronic stress activation), sleep apnea (untreated OSA causes hypertension), Type II diabetes, and certain medications. The Institute of Medicine's 2024 report finally established sufficient evidence linking PTSD to hypertension, strengthening secondary claims.
Hypertension is presumptive for Vietnam-era Agent Orange-exposed veterans under the PACT Act expansion (added 2022).
How to Establish Service Connection
- PACT Act added hypertension as a presumptive for Vietnam-era Agent Orange-exposed veterans.
- Secondary: hypertension secondary to PTSD or sleep apnea is well-supported in medical literature.
Rating Criteria
Paraphrased from 38 CFR § 4.104, Diagnostic Code 7101
| Rating | Criteria |
|---|---|
| 10% | Diastolic predominantly 100 or more; or systolic predominantly 160 or more; or minimum evaluation for an individual with a history of diastolic 100+ requiring continuous medication. |
| 20% | Diastolic predominantly 110 or more; or systolic predominantly 200 or more. |
| 40% | Diastolic predominantly 120 or more. |
| 60% | Diastolic predominantly 130 or more. |
See what each percentage pays in 2026 and how it combines with your current rating →
Evidence Checklist
- Two or more BP readings in the qualifying range.
- Prescription records showing continuous antihypertensive medication.
- Nexus letter for secondary claims (PTSD, sleep apnea, diabetes).
Evidence VA Commonly Cites in These Claims
Descriptive summary of evidence types frequently referenced in rating decisions for this condition. Not a checklist of actions to take — every claim is decided on its own facts.
- ★Pre-treatment blood pressure readings — the original elevated values, not just the current controlled values — are commonly central to the evaluation.
- ★Secondary connection is commonly evaluated where applicable: PTSD, OSA, diabetes, kidney disease.
- ★For Vietnam-era veterans, the PACT Act presumption applies and no nexus is required.
Common pitfalls VA sees
- Accepting a denial because current readings are normal on medication — the rule explicitly contemplates medicated control.
- Missing the PACT Act presumption for Agent Orange-exposed veterans.
Common Secondary Conditions
Conditions frequently service-connected as secondary to Hypertension:
Frequently Asked Questions
Have a Hypertension claim or denial?
Four fields. A VA-accredited claims agent reviews it and responds within 3–5 business days. Contingent fees apply only to awarded past-due benefits on appeals — never on initial claims.
Requesting a consultation does not create representation and is not a guarantee of any outcome. Representation begins only after a written fee agreement and VA Form 21-22a are signed.
Educational content only — not legal advice and not medical advice. Rating criteria on this page are summarized in plain English from 38 CFR Part 4; consult VA.gov or the current Code of Federal Regulations for official criteria. This page provides general education about how the VA rates this condition; it is not individualized advice, does not establish a representation relationship, and should not be used to self-diagnose, self-treat, or decide a course of action without speaking to a qualified clinician and a VA-accredited representative. Outcomes depend on each veteran's individual facts, evidence, and the adjudicator's judgment; no specific rating, effective date, or other result is guaranteed. Oakridge Claims is a private business and is not affiliated with, endorsed by, or operated by the US Department of Veterans Affairs.
Related Conditions
Coronary Artery Disease (Ischemic Heart Disease)
METs-based rating; Agent Orange presumptive.
Diabetes Mellitus Type II
Insulin, restricted diet, and regulation of activities; Agent Orange presumptive.
PTSD (Post-Traumatic Stress Disorder)
Service-connected PTSD ratings, common stressors, and evidence strategy.