BVA decisions by condition
Hypertension: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided a hypertension issue in 53,517 decisions. It granted the hypertension issue in 17.6% of them, close to the 19.4% grant rate for all conditions, denied it in 32.1%, and remanded it in 49.4%. Counting only decisions on the merits (granted or denied), 35.4% were granted.
Decisions
53,517
2017–2026
Granted
17.6%
All conditions: 19.4%
Granted on the merits
35.4%
Granted ÷ (granted + denied)
Remanded
49.4%
Denied: 32.1%
How VA rates hypertension
Once service connection is granted, VA assigns a disability rating from the rating schedule: 38 CFR 4.104, diagnostic code 7101 (Hypertensive vascular disease (hypertension and isolated systolic hypertension)). The rating is the same whether the condition is service connected directly or as secondary to another disability.
| Rating | Criteria |
|---|---|
| 60% | Diastolic pressure predominantly 130 or more |
| 40% | Diastolic pressure predominantly 120 or more |
| 20% | Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more |
| 10% | Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control |
- Note (1): Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm.
- Note (2): Evaluate hypertension due to aortic insufficiency or hyperthyroidism, which is usually the isolated systolic type, as part of the condition causing it rather than by a separate evaluation.
- Note (3): Evaluate hypertension separately from hypertensive heart disease and other types of heart disease.
Text of 38 CFR 4.104 as of Feb 27, 2026. Confirm the current text at the source before relying on it.
Hypertension outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 3,941 | 7.9% | 39.3% | 46.5% | 6.3% |
| 2018 | 6,350 | 9.9% | 38.4% | 48.5% | 3.3% |
| 2019 | 6,647 | 10.9% | 32.4% | 54.6% | 2.1% |
| 2020 | 6,503 | 11.4% | 33.0% | 53.6% | 1.9% |
| 2021 | 5,904 | 13.5% | 29.9% | 54.7% | 1.9% |
| 2022 | 5,814 | 21.2% | 23.4% | 53.2% | 2.2% |
| 2023 | 6,063 | 27.5% | 25.1% | 45.3% | 2.1% |
| 2024 | 5,731 | 25.0% | 29.9% | 43.0% | 2.0% |
| 2025 | 5,940 | 22.6% | 35.6% | 40.4% | 1.4% |
| 2026 | 2,301 | 25.3% | 32.5% | 40.9% | 1.3% |
Each row counts issues (each condition the Board decided), so the shares add up to 100%. Other: dismissed, withdrawn or no clear outcome. Years with fewer than 50 issues are left out.
Evidence in granted and denied hypertension decisions
For each kind of supporting evidence: how often the Board granted the hypertension issue on the merits when the decision mentioned it, compared with decisions that did not. These are associations, not causes, and evidence is recorded per decision, not per issue.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Positive nexus opinion | 8,385 | 64.7% | 28.3% | +36.5 pts |
| Favorable VA exam | 6,230 | 58.7% | 31.2% | +27.5 pts |
| Treating physician opinion | 2,678 | 50.8% | 34.4% | +16.4 pts |
| Combat service | 3,591 | 47.9% | 34.5% | +13.4 pts |
| Claimed as secondary | 14,997 | 45.6% | 32.7% | +12.9 pts |
| Buddy statement | 1,343 | 47.8% | 35.1% | +12.7 pts |
| Private medical opinion | 16,092 | 42.9% | 31.4% | +11.5 pts |
| Lay statement | 39,438 | 31.0% | 49.7% | −18.7 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 68.2% of the decisions that granted hypertension.
- The Board found the veteran's statements credible in 22.9% of grants and 10.7% of denials.
Negative evidence in the record
An unfavorable exam or a negative nexus opinion often sits in the same record as favorable evidence, and the Board weighs them against each other. So these rows show how often hypertension was still granted when the record contained the negative item, not that the item helped.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Negative nexus opinion | 26,634 | 32.1% | 38.9% | −6.9 pts |
| Unfavorable VA exam | 38,135 | 32.0% | 47.6% | −15.5 pts |
Hypertension claimed as a secondary condition
Decisions where hypertension was claimed as secondary to another service-connected disability (38 CFR 3.310), by that disability.
- Hypertension secondary to PTSD3,194 decisions · 16.5% granted
- Hypertension secondary to diabetes2,809 decisions · 15.2% granted
- Hypertension secondary to a psychiatric disorder1,487 decisions · 20.1% granted
- Hypertension secondary to sleep apnea511 decisions · 25.4% granted
- Hypertension secondary to a back condition330 decisions · 20.0% granted
Conditions claimed secondary to hypertension
Other conditions veterans claimed as caused or aggravated by hypertension, with how often the Board granted them.
- Sleep apnea secondary to hypertension692 decisions · 14.6% granted
- Erectile dysfunction secondary to hypertension648 decisions · 36.7% granted
- Kidney disease secondary to hypertension528 decisions · 37.1% granted
- Diabetes mellitus secondary to hypertension467 decisions · 14.6% granted
- Migraine secondary to hypertension346 decisions · 23.7% granted
Why the Board granted or denied hypertension
Most common reasons in grants
- Current diagnosis established1,305
- Requires continuous medication for control321
- Caused by the service-connected disability306
- Service connection established211
- History of diastolic pressure predominantly 100 or more192
- Continuity of symptomatology since service164
- Aggravated by the service-connected disability122
- Criteria for service connection met115
Most common reasons in denials
- No in-service complaints, treatment or diagnosis2,028
- Preponderance of the evidence against the claim1,868
- VA examiner: less likely than not related to service1,656
- Service records negative or silent1,192
- No current diagnosis836
- No continuity of symptomatology608
- Current diagnosis established378
- No history of diastolic pressure predominantly 100 or more333
Numbers are decisions that gave the reason. Reasons are short phrases extracted by AI from each decision; common wordings of the same reason are grouped. Benefit of the doubt is reported above.
Recent hypertension decisions
Granted
Veteran presumed exposed to herbicide agents in Vietnam; Veteran has diagnosis of hypertension; PACT Act includes hypertension as disease with positive association to herbicide exposure
Favorable finding of current heart condition; Service-connected hypertension established; Prohibitive VA opinion linking hypertension to atrial fibrillation
Mild left ventricular hypertrophy found on Feb 10, 2021 echocardiogram.; Met criteria for 30% rating under DC 7005.; Benefit of doubt applied due to approximate balance of evidence.
Denied
No evidence of in-service incurrence or aggravation; No nexus to service or claimed exposures; Hypertension did not originate in service, within a year of service, or is not otherwise etiologically related to active service
Hypertension claimed secondary to diabetes mellitus, which was not service-connected.; Condition did not onset during service or within one year of separation.; No continuity of symptoms from service to diagnosis.
Blood pressure readings do not meet criteria for higher ratings; Not on continuous medication for hypertension; No diastolic pressure of 100 or more recorded
Rules that apply to hypertension claims
- 38 CFR 4.104 · DC 7101
Schedule of ratings: cardiovascular system
Read it in VA Law Explorer - M21-1 V.iii.5.3
Hypertension: definitions, blood pressure readings required, predominant blood pressure
Read it in VA Law Explorer - M21-1 V.iii.11.2.e
When hypertension is or is not a complication of diabetes
Read it in VA Law Explorer - 38 CFR 3.303
Principles of service connection
Read it in VA Law Explorer - 38 CFR 3.310
Secondary service connection and aggravation
Read it in VA Law Explorer - 38 CFR 3.102
Reasonable doubt (benefit of the doubt)
Read it in VA Law Explorer
Research your hypertension case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.
How these numbers are calculated
- Rates count decisions in which the Board decided a hypertension issue, by the outcome of that issue. Other issues in the same decision can have different outcomes.
- “Granted on the merits” leaves out remands and dismissals. “All conditions” is the grant share across every condition issue in the data.
- The data comes from CaseScribe's AI extraction of public BVA decisions (2017–2026) and can contain errors. It is updated automatically as new decisions are added.