“Studies have shown around half of the U.S. population either has or is at risk for hypertension. Veterans are at an even higher risk. Research shows that an alarming rate of young, active-duty service members have the condition. So, what exactly is hypertension? What causes it? How is it linked to military service, and what is the VA’s response?
“Hi, I’m Melissa Alexander, a VA-accredited attorney at Wood and Woods, a law firm that represents veterans and their VA disability appeals. Today, we’ll discuss hypertension’s history, its prevalence amongst servicemembers, and how the government compensates veterans who have it.”
What is hypertension?
“Hypertension is the medical term for having high blood pressure. Blood needs to move throughout your whole body. It’s the heart’s job to pump it. As the heart pumps the blood, it puts pressure against the walls of your arteries, and this is what people are describing when they use the term blood pressure.
“Now, these readings are not constant, even in the healthiest of people. It naturally goes up or down throughout the day. It changes when you sleep, eat, and walk. However, experiencing consistently elevated blood pressure levels can be hazardous to your health.
“Essentially, hypertension is when the force of blood flowing through the arteries is too strong for long amounts of time. It is a common condition. Many people don’t have it under control and may be undiagnosed. That’s likely because hypertension can be asymptomatic. Symptoms can include dizziness, headaches, chest pain, or difficulty breathing. But more often than not, people don’t have any symptoms until they experience a major cardiovascular event.
“That’s why it’s taken over a century for doctors to develop our modern understanding of its long-term effects, and they still don’t fully understand the prevalence in military personnel and veterans.”
Discovery of hypertension
“There’s evidence that suggests the medical community has had a concept of blood pressure and its health effects for over 200 years. In the 19th century, doctors observed that high blood pressure often accompanies kidney disease, but they didn’t know the extent of hypertension among the general population.
“Our modern understanding of hypertension can be traced back to the early 1870s when a medical resident developed a way to measure blood pressure. He also discovered that high blood pressure is more likely in older populations and affects the heart, kidneys, and brain.
“In the early 20th century, we see the first use of a medical device we’re all familiar with — a hand pump attached to a band that tightens around your arm. To this day, a blood pressure cuff and a stethoscope are used to measure a patient’s systolic and diastolic blood pressure readings.”
“The systolic number is the pressure in your arteries when your heart beats. The diastolic number measures the pressure when your heart rests between beats. So, if the measurement reads 120 systolic and 80 diastolic, you would say 120 over 80, or write it as a fraction, 120/80.”
Hypertension treatment history
“Even though we have been measuring blood pressure for well over a century and have since learned the risk of high blood pressure, it wasn’t dubbed a significant public health concern until the 1960s. That’s when we realized that high blood pressure causes heart attacks, heart failure, stroke, and chronic renal damage.
“Then we began looking for ways to effectively treat hypertension. Believe it or not, the advancements and treatments are largely attributed to the Department of Veterans Affairs.
“At that time, some doctors believed that elevated blood pressure was necessary to pump blood through congested arteries. In 1970, a VA study group disproved that theory. The study found that certain medications reduced cardiovascular events and improved mortality rates.”
VA rating for hypertension
“How is hypertension connected to military service and how do veterans get a VA rating for the condition?
“Interestingly enough, hypertension was one of the first conditions listed in the original VA rating system, which we now call the Schedule of Ratings.
“It’s a huge list of conditions that veterans can be compensated for as a result of military service. Each condition is assigned ratings from 0% to 100% that are based on the severity of symptoms and the level of functional impact a condition has on a veteran’s life. A rating ultimately determines how much a veteran is paid. If you want a more in-depth explanation of how these ratings work, watch our video on VA math.
“Hypertension is found in the ratings schedule under diagnostic code 7101 and is listed as hypertensive vascular disease. Its ratings are 10%, 20%, 40%, and 60%. The higher a veteran’s blood pressure readings, the higher the rating.
“When the VA began rating hypertension, it only measured the severity based on the diastolic reading, which I mentioned before is a second or bottom number. Today, the VA uses both numbers to determine a veteran’s rating. The VA ratings for hypertension are:
- 10% for diastolic pressure of 100 or more, or systolic of 160 or more
- 20% for diastolic of 110 or more, or systolic of 200 or more
- 40% for diastolic of 120 or more
- 60% for diastolic of 130 or more
“Now, veterans who take medication to control their blood pressure might think they aren’t eligible for compensation. That’s not the case. The VA considers the veteran’s use of continuous medication to control blood pressure in its criteria for ratings. To learn more about how the VA rates hypertension, you can read our blog post.”
“From the day we contacted [Woods and Woods], they made us feel so comfortable. They treated us like we mattered and we were not just clients but family.”
L.B., a Navy veteran and wife in Florida
Service Connecting Hypertension
“If you know anything about VA disability benefits, you know that the VA will only compensate veterans for conditions that were caused or aggravated by service. So how do veterans connect hypertension to service?
“To fully understand service connection for hypertension we need to discuss its potential causes.
“There are a lot of factors that increase blood pressure. Some are completely out of our control, like genetics or aging. Other risk factors include obesity, diabetes, harmful levels of alcohol use, physical inactivity, and elevated stress levels. It’s not always obvious how those risk factors can lead to the development of hypertension during military service. We’ll talk about that in a little bit. There are, however, many factors that put military personnel at an increased risk for the condition.”
Hypertension as a presumptive condition
“First, hypertension is considered a presumptive condition for service members who are diagnosed within one year of discharge, or if diagnosed during service. The VA automatically assumes presumptive conditions are service related without the veteran having to prove the connection.
“Hypertension is also a presumptive condition for Vietnam-era veterans exposed to Agent Orange.
“The VA has been compensating veterans for a wide range of illnesses on a presumptive basis since 1985. In 2022, it added hypertension to the list.
“This was a major win for Vietnam vets and their families. It opened the door for veterans to service connect the numerous conditions that hypertension contributes to.
“Additionally, widows of Vietnam veterans who otherwise wouldn’t get DIC benefits now can if hypertension was listed as a contributory cause of death on the veteran’s death certificate. We have a great video that explains this in more detail. If you think this might apply to you or someone you know, I suggest checking it out.”
Hypertension as a secondary condition
“Veterans can also receive VA disability benefits through a secondary service connection, which is when a service-connected condition causes another condition. There is an extensive list of conditions that cause or are caused by hypertension. Let’s talk about a few connections that we see here at the firm.
“Numerous studies have linked hypertension with mental health conditions, especially PTSD. Stress alone can raise blood pressure. Those who struggle with their mental well-being are also prone to using food and/or alcohol as coping mechanisms. All of these factors can combine to cause hypertension, entitling a veteran to additional compensation.
“This principle applies to other types of conditions as well. For example, a physical disability that results in partial or full immobility can lead to weight gain, which can contribute to hypertension. A veteran in this circumstance could claim hypertension on a secondary basis. Sleep apnea is another common way we connect hypertension to service.”
“After trying and failing multiple times over many years to get widow’s compensation from the VA, I turned to Woods and Woods… I am so glad we found them. They are wonderful and very good at what they do. They are very professional and keep you updated and formed throughout the process.”
J.C., a veteran’s widow in Utah
Conditions secondary to hypertension
“So, you might be wondering if it’s worth service connecting hypertension if you expect a low rating. I’d argue that it is.
“Even if you receive a 10% rating, that opens the door for you to later connect serious health conditions caused by hypertension, including heart attack, stroke, aneurysms, chronic kidney disease, heart failure, diseases of the arteries, and vascular dementia. All of these cardiovascular events can have a devastating impact on your life, so much that you may not be able to work like you did before, if at all.
“I can’t tell you how often our clients don’t mention they are being treated for hypertension until we ask. In many cases, getting that rating can make or break a case. Hypertension can be the link to serious health problems down the line.
“Going through the process of service connecting it now, even if you only get 10%, can help you later when you need to file for more serious conditions that can lead to higher VA compensation.”
How Woods and Woods can help
“If you have more questions about VA benefits in general, please watch some of our other videos on our YouTube channel. If you’re wondering if you qualify for an increased rating, you can contact Woods and Woods for a free consultation.”
Talk to Us About Your Claim:
(812) 426-7200
Melissa Alexander
VA disability attorney
Woods and Woods
Melissa is a National Guard veteran who deployed to Afghanistan in 2009 before later deciding to pursue a law degree. She joined our team in 2022
U.S. Departments of Veterans Affairs Accreditation Number: 52908
