If a patient has Stage 3 Hypertension and a blood pressure over 140/90, what is the appropriate recommendation?

In the context of Stage 3 Hypertension, which is classified as having a blood pressure reading demonstrably above 180 systolic or 110 diastolic, the best course of action is to not certify the patient. This recommendation is based on the understanding that Stage 3 Hypertension poses significant risks that can impact the individual's ability to operate a commercial vehicle safely.

The presence of high blood pressure can lead to severe health complications, including heart attack, stroke, and other cardiovascular issues, especially when left uncontrolled. Therefore, it’s crucial to prioritize the safety of the driver, other road users, and the overall public. Not certifying the patient until their hypertension is appropriately managed and under control ensures that the patient receives necessary medical attention and treatment before considering them fit for driving.

In scenarios involving follow-up recommendations or temporary certifications, these would typically apply to patients whose hypertension is under better control or at a lower stage. In this instance, due to the severity of Stage 3 Hypertension, the most responsible recommendation is to not certify.