If a patient has been issued a 3-month certification but returns with a blood pressure greater than 140/90, what is the recommendation?

In the context of DOT physicals, a blood pressure reading greater than 140/90 typically indicates that the individual may have uncontrolled hypertension, which poses a higher risk for cardiovascular complications. When a driver is certified, the medical examiner must ensure that their health conditions, particularly blood pressure, are monitored and controlled effectively to ensure safety on the road.

In this scenario where a patient returns with elevated blood pressure that exceeds the recommended threshold, the prudent course of action is to not certify them at this time. This decision takes into account the importance of managing health conditions that could affect driving safety. Instead of certifying the patient, it's essential that they seek proper medical management to address their high blood pressure before obtaining clearance for driving.

While follow-up appointments or medication adjustments might be necessary, immediate certification would not be appropriate given the elevated blood pressure. Thus, the recommendation to not certify reflects the medical examiner’s responsibility to prioritize both the driver’s health and public safety.