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View Full Enhanced Guide →38 CFR Part 4 — 38 CFR § 4.104
Hypertensive Vascular Disease
dc-7101-hypertensive-vascular-disease
Cardiovascular
Diagnostic code
7101
Why your DC matters: DC 7101 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7101 — Hypertensive Vascular Disease — covers high blood pressure and related cardiovascular complications, listed under 38 CFR § 4.104.
Hypertension can be rated at 10%, 20%, 40%, or 60% based on diastolic blood pressure readings and the presence of complications (heart disease, kidney disease, eye damage).
For a comprehensive guide with visual compensation breakdowns, secondary conditions, evidence strategies, and claim timelines, visit the detailed guide page for this condition.
Exact rating criteria: 10% for diastolic pressure predominantly 100 or more, 20% for diastolic 110 or more, 40% for diastolic 120 or more, 60% for diastolic 130 or more. Higher ratings may apply if there is evidence of cardiac hypertrophy or other organ damage.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7101 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7101 in the subpart for your body system (use Find in Page if needed).
Hypertension is one of the most under-rated conditions because veterans show up to the C&P with one good blood pressure reading and the examiner uses that single number. The rule is 'predominantly' — multiple readings on multiple days. Bring your home BP log.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 60% | Diastolic pressure predominantly 130 or more. | Multiple BP readings across multiple days documenting severe diastolic elevation despite treatment. |
| 40% | Diastolic pressure predominantly 120 or more. | Multi-day reading log; usually requires multiple antihypertensive medications and still poor control. |
| 20% | Diastolic predominantly 110+, OR systolic predominantly 200+. | Two or more readings on at least three different days at this threshold. |
| 10% | Diastolic predominantly 100+, OR systolic predominantly 160+, OR history of diastolic 100+ now requiring continuous medication for control. | Pharmacy records showing continuous antihypertensive Rx + chart history showing pre-treatment readings ≥100 diastolic. |
What Qualifies as 'Hypertensive Vascular Disease' Under DC 7101?
Confirmed hypertension diagnosis
Per Note (1) to § 4.104, hypertension must be confirmed by readings taken two or more times on at least three different days. A single high reading is insufficient.
'Predominantly' threshold reading
Ratings use the 'predominantly' standard — most readings (not all, not the average) at or above the tier threshold. Bring a 30-day home BP log to anchor this.
- • 10% — diastolic predominantly 100+ OR systolic 160+, OR controlled by continuous medication after a history of 100+ diastolic
- • 20% — diastolic predominantly 110+ OR systolic 200+
- • 40% — diastolic predominantly 120+
- • 60% — diastolic predominantly 130+
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“History of diastolic pressure predominantly 100 or more, requiring continuous medication for control”
This is the most overlooked path to a 10% minimum rating. Even if your BP is now controlled, if your chart shows pre-medication readings ≥100 diastolic, you qualify. Pull your earliest BP records.
“Readings taken two or more times on at least three different days”
Per Note (1) to § 4.104, hypertension must be confirmed by readings across multiple days. A single high reading doesn't qualify; a single low reading doesn't disqualify.
“Predominantly [X] or more”
'Predominantly' means most readings — not all, not the average. If 4 out of 6 readings are ≥100 diastolic, you meet the threshold even if 2 are normal.
Evidence Checklist — Specific to This Condition
Home BP log (3+ readings/day, 30+ days)
CRITICALStrongest single piece of evidence. Take readings AM/midday/PM for at least a month. Brings 'predominantly' into focus.
Pharmacy printout of antihypertensive history
CRITICALEstablishes continuous medication for control — the gateway to a 10% rating even with current normal numbers.
Pre-treatment BP readings from STRs or earliest civilian records
IMPORTANTIf diastolic was ≥100 before meds, you qualify for 10% no matter how good your control is now. Vital for in-service onset claims.
Hypertension DBQ
IMPORTANTStandard cardiovascular DBQ. Make sure the examiner notes both current readings AND treatment history.
C&P Exam Tips
Bring your home log to the exam
C&P examiners take 1–3 readings. Hand them a 30-day log so they document 'history' and 'predominantly,' not just today's number.
Don't take your meds 'extra carefully' before the exam
Take them as prescribed — but don't sandbag. If you skip stress/caffeine for 24h to get a good reading, you're undermining your claim. The exam should reflect typical control.
Tell the examiner about every medication trial
If you needed two or three drugs before finding a working combo, that's evidence of severity. Refractory hypertension supports higher ratings.
Common Mistakes That Cost Veterans Points
Filing for hypertension without pulling in-service BP readings
Service connection is hardest part. Pull your STRs — look for any reading ≥140/90 during service or within one year of separation (presumptive).
Letting one C&P reading set the rating
A single 138/88 at C&P does not refute 30 days of home readings at 165/105. File a supplemental claim with the log.
Not claiming hypertension secondary to PTSD
PTSD is well-established as causing/aggravating hypertension. If you're rated for PTSD and have HTN, file as secondary — no in-service BP reading required.
Tactical Plays
⚡ PTSD secondary path bypasses service-onset evidence
If you can't show in-service BP elevation, file HTN as secondary to a service-connected mental health condition. The medical literature on stress-induced hypertension is strong enough that a single nexus letter from a primary care doc usually wins.
⚡ The 30-day home log trumps everything
Buy an automated BP cuff from any pharmacy. Take 3 readings/day for 30 days. Log every one. This single piece of evidence regularly bumps veterans from denied → 10% → 20% on appeal.
⚡ Re-rate when meds are added or doses go up
Each time your provider adds a med or raises a dose, that's evidence the condition is worsening despite treatment. File for an increase with the new prescription record.
Secondary Conditions to File With This One
Chronic kidney disease / nephropathy
MODERATEDC 7530
Sustained hypertension damages kidneys. Lab eGFR < 60 = compensable nephropathy on top of HTN.
Hypertensive heart disease
MODERATEDC 7007
LVH on echo + symptoms. Higher payout potential than HTN alone.
Coronary artery disease
MODERATEDC 7005
If HTN preceded CAD and you have METs limitation, file CAD as secondary.
Erectile dysfunction
MODERATEDC 7522
HTN + antihypertensive meds are well-documented ED causes. Unlocks SMC-K.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Continuous medication required, or diastolic predominantly 100+.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Diastolic predominantly 110+, or systolic 200+.
40% — single, no dependents
Base rating
$795.84
TOTAL
$795.84/mo
Diastolic predominantly 120+.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Diastolic predominantly 130+.
60% with spouse + 1 child
Base rating
$1,435.02
Dependents (spouse + 1 child)
+$207.43
TOTAL
$1,642.45/mo
Severe refractory hypertension with full family — dependents add ~$207/mo at 60%.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
📊What does 'Predominantly' mean?
Per § 4.104 Note 1, 'predominantly' means the majority of readings across multiple days — not all of them, not the arithmetic average. If 4 of 6 readings hit 110+ diastolic, you meet the 20% threshold.
💊What is 'Continuous Medication for Control'?
Daily antihypertensive therapy that you can't stop without BP rising. The 10% floor applies even when current numbers are normal, as long as your chart shows pre-treatment diastolic 100+.
🩸Why does a 30-day home log matter?
C&P exams capture 1–3 readings on one day. A home log with 90+ readings across 30 days lets the rater apply 'predominantly' to your real BP, not a single office snapshot.
How to File Your Claim
Start a 30-day BP log NOW
Buy an automated cuff. Take 3 readings/day (AM, midday, PM). Note any symptoms (headache, dizziness, chest pressure). This single piece of evidence regularly bumps veterans from denied → 10% → 20% on appeal.
File VA Form 21-526EZ listing 'hypertensive vascular disease'
Use the DC 7101 phrasing, not 'high blood pressure.' List secondary conditions (CKD, CAD, HTN heart disease) separately if applicable.
Attach pharmacy printout + STR BP readings
Pre-treatment readings ≥ 100 diastolic in your service records OR civilian early records unlock the 10% floor even when current control is good.
Consider PTSD-secondary pathway
If you're already rated for any mental health condition, file HTN as secondary. The medical literature on stress-induced hypertension is strong; a single PCP nexus letter typically wins.
Re-file for increase when meds escalate
Each time your provider adds a med or raises a dose, that's evidence of worsening despite treatment. Re-file with the new prescription record.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
One C&P reading does NOT trump 30 days of home readings
If your C&P shows 138/88 but your home log shows 165/105 on most days, file a supplemental claim with the log. 'Predominantly' is a multi-day, multi-reading standard.
The 10% 'history' path is the most overlooked entry point
Even with perfect current control, a documented history of diastolic 100+ pre-treatment + continuous medication = 10% rating. Pull your earliest BP records.
File HTN secondary to PTSD if direct SC fails
Can't show in-service BP elevation? Stress-induced hypertension secondary to a service-connected mental health condition is a well-trodden, high-success pathway.
Watch for kidney and heart secondaries
Sustained HTN damages kidneys (DC 7530 nephropathy if eGFR < 60) and heart (DC 7007 hypertensive heart disease if LVH on echo). Both rate separately on top of HTN.
Related Tools & Resources
Frequently Asked Questions
Can I get a hypertension rating if I'm well-controlled on medication?
Yes. The 10% rating includes the path 'history of diastolic 100+ requiring continuous medication for control.' Current numbers don't have to be elevated — the historical reading + ongoing medication establishes entitlement.
What's the difference between essential and secondary hypertension for VA?
DC 7101 rates both the same. The distinction matters for service connection: secondary hypertension (caused by a service-connected condition like PTSD, CKD, or sleep apnea) often has an easier nexus path than essential HTN that started in service.
Does a single high reading at C&P count?
No. Per Note 1 to § 4.104, readings must be confirmed two or more times on at least three different days. Bring a home log — a single reading at C&P (high OR low) is not determinative.
Can I be rated for HTN AND HTN heart disease?
Yes, but only if there are distinct disabilities. HTN (DC 7101) rates the blood pressure; hypertensive heart disease (DC 7007) requires LVH or evidence of cardiac involvement. Both can be combined when both are documented.
Is there a presumptive path for hypertension?
Hypertension is presumptive under the PACT Act for veterans with toxic exposure (burn pits, etc.) effective late 2024. Verify your exposure history with a VSO — eligibility is condition-, location-, and time-period-specific.
Official Regulatory Source
Hypertensive vascular disease is rated under 38 CFR § 4.104, Diagnostic Code 7101.
38 CFR § 4.104 — Cardiovascular System (eCFR) →Note (1) to § 4.104 defines the multi-day reading requirement.
⚠️ Verify with a VSO
VA published updated cardiovascular rating criteria — verify which version applied on your effective date with a VSO if your claim crosses the rule-change boundary.
Next Steps
If your rating decision lists DC 7101, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7101 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.