Last updated: 31 October 2026
Book your HGV / D4 medical with Dr Steve Walton, Sheffield S12: £80, 30-minute GP examination
The DVLA rule for lorry and bus drivers
According to GOV.UK and DVLA's Assessing fitness to drive guidance:
- You don't need to tell DVLA if your blood pressure is consistently below 180/100 mmHg. You can keep driving.
- You must stop driving and tell DVLA if your resting blood pressure is consistently 180 mmHg systolic or higher and/or 100 mmHg diastolic or higher. Use form BP1V.
- You must also stop driving and tell DVLA if a doctor diagnoses malignant (accelerated) hypertension. Use form VOCH1.
- You can be relicensed once your blood pressure is controlled, provided your treatment has no side effects that affect safe driving.
Note that it is either number. A reading of 165/102 breaches the diastolic limit even though the top number is under 180.
How blood pressure is checked at the D4 medical
Section 3g of the D4 must always be completed. The doctor records your best resting blood pressure on the day. If the first reading is 180 systolic or 100 diastolic or more, two further readings are taken at least 5 minutes apart and the best of the three is recorded. The doctor also notes whether you're on treatment and, if so, three previous readings with dates if available.
In my experience, many drivers have "white coat hypertension": their blood pressure goes up just because they are being examined, which inflates the reading. If the first reading is high, I often ask the driver to sit quietly in a room on their own, without a doctor present, for a few minutes, and then I check it again.
What happens if my blood pressure is too high on the day?
If your blood pressure is still above 180/100 after that, I encourage you to monitor it at home and have your own GP review the readings. Once your GP is happy that your blood pressure is controlled, you come back for another D4 appointment.
How to prepare for your HGV medical
- Keep taking your tablets as normal on the day, including the morning dose.
- Bring recent readings, from your GP practice, pharmacy or a home monitor, with dates. The D4 asks for previous readings if you're on treatment.
- Avoid caffeine, nicotine and energy drinks for an hour or so before the appointment, and arrive with time to sit and settle.
- If you haven't had your blood pressure checked for a while, get it checked a few weeks before the medical. Anyone can ask a local chemist to check their blood pressure.
Blood pressure tablets and driving
Most blood pressure medicines don't affect driving. Occasionally some cause dizziness, especially when starting or when the dose goes up. If you feel light-headed or faint, don't drive and speak to your doctor. Fainting or dizziness may be reportable in its own right. Low blood pressure doesn't need reporting unless it causes symptoms such as dizziness or fainting.
Why it matters beyond your licence
Long hours sitting, irregular meals, poor sleep and stress all push blood pressure up. Untreated hypertension raises the risk of stroke and heart attack, both of which would take you off the road for much longer. A lorry or bus licence is refused for a year after a stroke or TIA, for example. The D4 is a good prompt to get it under control.
Measuring your blood pressure at home
A validated upper-arm home monitor is a good investment if you're on treatment. Sit quietly for five minutes with your back supported and arm resting at heart level. Take two readings a minute apart, morning and evening, for several days, and write them down with the dates. Bring this record to your GP review and to your D4 medical. It gives a far truer picture than a single reading in a clinic, and it shows the examiner your blood pressure is under control.
If your home readings are regularly near or above 180/100, don't wait for your medical. See your GP or practice nurse promptly, as your treatment probably needs adjusting. Seek urgent medical help if a very high reading comes with severe headache, chest pain, breathlessness, confusion or changes in your vision.
Related conditions
High blood pressure often goes with sleep apnoea, diabetes and heart disease, which have their own Group 2 rules.
Book your HGV medical in Sheffield
A full 30-minute D4 examination with me at Stonecroft Medical Centre, a CQC-registered practice in Sheffield S12, costs £80. Appointments are Monday to Wednesday evenings.
Book your HGV / D4 medical with Dr Steve Walton, Sheffield S12: £80, 30-minute GP examination
Frequently asked questions
What blood pressure is too high for an HGV licence?
DVLA requires lorry and bus drivers to stop driving and notify if their resting blood pressure is consistently 180 mmHg systolic or higher, or 100 mmHg diastolic or higher, or if they have malignant hypertension.
Do I need to tell DVLA I take blood pressure tablets?
No. You only need to tell DVLA if your blood pressure is consistently 180/100 or above, you have malignant hypertension, or treatment causes side effects that affect driving.
What if my blood pressure is high at the D4 medical?
If the first reading is 180/100 or more, the doctor takes two more at least 5 minutes apart and records the best of the three.
Which form do I use to tell DVLA about high blood pressure?
Lorry and bus drivers use form BP1V for blood pressure consistently above 180/100, and VOCH1 for malignant hypertension.
Do car drivers need to report high blood pressure?
No. Car and motorcycle drivers don't need to tell DVLA about high blood pressure, but must stop driving if diagnosed with malignant hypertension until it is controlled.
Sources (GOV.UK / DVLA)
- High blood pressure and driving (GOV.UK)
- Assessing fitness to drive, chapter 2: Hypertension (GOV.UK)
- D4 form, section 3g (GOV.UK)
Medical standards checked against DVLA's Assessing fitness to drive (November 2025 edition) and GOV.UK guidance, October 2026. Always check GOV.UK for the latest rules.