Hypertension VA claims: secondary to PTSD, diabetes and what the Board grants

What does VA need to diagnose hypertension?

Readings taken two or more times on at least three different days, under the first note to DC 7101 in 38 CFR 4.104. The same note sets the blood pressure levels that count as hypertension, and as isolated systolic hypertension. VA rates it from 10 to 60 percent by how high the readings run.

The readings rule matters. A single high reading at a clinic visit, or a diagnosis of "pre-hypertension", is not enough. Records that show readings on three separate days, and a current VA exam, are what both the diagnosis and the rating rest on.

Hypertension claimed secondary to another condition

Can hypertension be secondary to PTSD?

Yes, under 38 CFR 3.310, with a medical opinion that explains the link. PTSD is the condition hypertension is most often claimed secondary to, but the Board granted only 340 of 1,889 of those claims (18.0%).

Among conditions claimed as secondary at the Board, only sleep apnea and nerve damage in the legs come up more often. Most hypertension claims of this kind are made secondary to a mental health condition or diabetes.

Granted

All hypertension claims

20.1%

Sleep apnea

24.9%

Depression (major depressive disorder)

24.7%

Back condition

22.3%

PTSD

18.0%

Diabetes

17.8%

Mental health condition (not specified)

15.0%

Coronary artery disease

13.6%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Secondary claims are the ones the Board marked as secondary to that condition.

Claimed secondary to	Granted	Veterans	Share
PTSD	340	1,889	18.0%
Diabetes	274	1,539	17.8%
A mental health condition (not specified)	85	568	15.0%
Sleep apnea	106	426	24.9%
Back condition	55	247	22.3%
Coronary artery disease	32	235	13.6%
Depression (major depressive disorder)	45	182	24.7%
Knee condition	36	168	21.4%

Can hypertension be secondary to diabetes or sleep apnea?

Yes. Hypertension claimed secondary to diabetes was granted for 274 of 1,539 veterans (17.8%), and secondary to sleep apnea for 106 of 426 (24.9%).

A secondary claim needs a medical opinion that explains how the service-connected condition caused the hypertension or made it worse; under 38 CFR 3.310(b), aggravation counts as well as causation. In the first grant below, a private opinion explained how the PTSD led to the hypertension; in the second, the Board found the VA opinion inadequate.

Agent Orange and the PACT Act

Is hypertension presumptive for Agent Orange?

Yes, since the PACT Act took effect in August 2022, for veterans with presumed herbicide exposure (38 U.S.C. 1116; M21-1 VIII.i.1.A), with no set level of disability needed. In decisions that mention Agent Orange or other herbicides, the Board granted 36.3% of hypertension claims (3,636 of 10,008), against 20.1% overall.

Thai air bases did best: Udorn 53.7% (73 of 136), U-Tapao 45.2% (100 of 221) and Korat 48.4% (88 of 182). The Vietnam claim map linked above shows how grants for Vietnam veterans changed after the law took effect.

Is hypertension a chronic disease presumed within a year of service?

Yes. 38 CFR 3.309(a) lists cardiovascular-renal disease, including hypertension, and disabling hypertension within a year of discharge is presumed service connected (38 CFR 3.307(a)(3)).

What hypertension opens up

Once hypertension is service connected, the conditions it causes can be claimed secondary to it. The ones that follow from high blood pressure did well: hypertensive heart disease was granted for 139 of 283 veterans (49.1%), chronic kidney disease (nephritis) for 115 of 206 (55.8%) and a stroke from bleeding in the brain for 70 of 194 (36.1%). Erectile dysfunction was granted 38.8% (179 of 461). Sleep apnea was the most common claim of this kind but did poorly: 16.5%. Under the third note to DC 7101, hypertension is rated separately from heart disease.

Look up your client's group

Every base, exposure, job and medal with at least 15 decided hypertension claims, 190 groups in all; 14 fall under a presumption.

Bases 78Exposures 43Military jobs 37Medals 32

Bar: share of this group's hypertension claims the Board granted. Red line: all hypertension claims, 20.1% granted. A bar past the line won more often than usual.

×

More often than usual: how much more often hypertension comes up in this group's decisions than in all Board decisions. It shows how common the condition is here, not how often it wins.

Set aside

For groups VA does not presume, veterans whose decision shows service VA already presumes for hypertension (for example Vietnam or Thailand for Agent Orange) are left out, because for them the presumption is the answer.

Sort byGrant shareMore often than usualClaims decided

• Udorn Royal Thai Air Force Base, Thailand

  Presumed by law · 38 U.S.C. 1116(a)(2)
  53.7% granted · 73 of 136

  1.6×more often

• Takhli Royal Thai Air Force Base, Thailand

  Presumed by law · 38 U.S.C. 1116(a)(2)
  50.5% granted · 47 of 93

  2.1×more often

• Ubon Royal Thai Air Force Base, Thailand

  Presumed by law · 38 U.S.C. 1116(a)(2)
  48.7% granted · 38 of 78

  2.1×more often

• Royal Thai Air Force Base (RTAFB) in Korat, Thailand

  Presumed by law · 38 U.S.C. 1116(a)(2)
  48.4% granted · 88 of 182

  2.2×more often

• Nakhon Phanom Royal Thai Air Force Base, Thailand

  Presumed by law · 38 U.S.C. 1116(a)(2)
  45.3% granted · 43 of 95

  2.3×more often

• U-Tapao Royal Thai Air Force Base, Thailand

  Presumed by law · 38 U.S.C. 1116(a)(2)
  45.2% granted · 100 of 221

  2.3×more often

• Tan Son Nhut Air Force Base

  Presumed by law · 38 U.S.C. 1116(a)(2)
  43.8% granted · 14 of 32

  1.9×more often

• Andersen AFB, Guam

  Presumed by law · 38 U.S.C. 1116(a)(2)
  38.8% granted · 19 of 49

  2.1×more often

• Vung Tau Air Base

  Presumed by law · 38 U.S.C. 1116(a)(2)
  37.5% granted · 6 of 16

  3.1×more often

• Bien Hoa Air Force Base

  Presumed by law · 38 U.S.C. 1116(a)(2)
  35.3% granted · 6 of 17

  2.1×more often

• Johnston Atoll

  Presumed by law · 38 U.S.C. 1116(a)(2)
  32.3% granted · 10 of 31

  2.9×more often

• Da Nang AFB

  Presumed by law · 38 U.S.C. 1116(a)(2)
  31.6% granted · 66 of 209

  2.1×more often

• Cam Ranh Bay Air Base

  Presumed by law · 38 U.S.C. 1116(a)(2)
  31.0% granted · 13 of 42

  1.9×more often

• Fort Ord
  19.2% granted · 5 of 26 · 14 with presumptive service set aside

  1.1×more often

• Fort Polk
  19.2% granted · 5 of 26 · 23 with presumptive service set aside

  1.1×more often

• Fort Gordon (Eisenhower)
  16.0% granted · 4 of 25 · 47 with presumptive service set aside

  1.5×more often

• Marine Corps Base Camp Pendleton, California
  16.0% granted · 8 of 50 · 26 with presumptive service set aside

  1.1×more often

• Fort Lee, Virginia
  13.3% granted · 2 of 15 · 12 with presumptive service set aside

  1.9×more often

• Fort Dix, NJ
  11.8% granted · 4 of 34 · 20 with presumptive service set aside

  1.1×more often

• Fort Stewart
  11.8% granted · 2 of 17 · 1 with presumptive service set aside

  0.9×more often

• Camp Lejeune
  10.3% granted · 58 of 562 · 206 with presumptive service set aside

  1.3×more often

• Fort Sill, Oklahoma
  7.7% granted · 2 of 26 · 6 with presumptive service set aside

  0.9×more often

• Fort Bragg
  7.4% granted · 4 of 54 · 19 with presumptive service set aside

  1.1×more often

• Fort Knox
  6.5% granted · 2 of 31 · 23 with presumptive service set aside

  1.1×more often

• Fort Riley
  5.9% granted · 1 of 17 · 5 with presumptive service set aside

  1.1×more often

• Fort Sam
  5.9% granted · 1 of 17 · 4 with presumptive service set aside

  1.5×more often

• Fort Hood
  5.6% granted · 3 of 54 · 20 with presumptive service set aside

  1.0×more often

• Fort Campbell
  5.3% granted · 1 of 19 · 18 with presumptive service set aside

  0.9×more often

• Fort Carson
  5.0% granted · 1 of 20 · 25 with presumptive service set aside

  1.7×more often

• Fort Jackson
  3.7% granted · 2 of 54 · 17 with presumptive service set aside

  1.2×more often

• Fort McClellan, Alabama
  2.4% granted · 2 of 83 · 133 with presumptive service set aside

  1.6×more often

• Fort Benning
  0.0% granted · 0 of 37 · 26 with presumptive service set aside

  0.9×more often

• Fort Bliss
  0.0% granted · 0 of 25 · 6 with presumptive service set aside

  1.1×more often

• Fort Lewis, Washington
  0.0% granted · 0 of 16 · 12 with presumptive service set aside

  0.9×more often

• Lackland AFB, Texas
  0.0% granted · 0 of 20 · 8 with presumptive service set aside

  1.1×more often

43 more groups: too few claims to judge once veterans with presumptive service are set aside

• USS Kearsarge: 1 of 15 claims left, 14 set aside
• Subic Bay Naval Station: 5 of 68 claims left, 63 set aside
• Camp Red Cloud: 2 of 23 claims left, 21 set aside
• Clark Air Force Base, Philippines: 6 of 39 claims left, 33 set aside
• USS Midway: 4 of 24 claims left, 20 set aside
• USS Ticonderoga: 2 of 22 claims left, 20 set aside
• Keesler Air Force Base: 12 of 18 claims left, 6 set aside
• Osan Air Force Base: 3 of 19 claims left, 16 set aside
• USS Coral Sea: 7 of 43 claims left, 36 set aside
• Aberdeen Proving Grounds, Maryland: 10 of 37 claims left, 27 set aside
• Fort Leonard Wood, Missouri: 10 of 30 claims left, 20 set aside
• USS Ranger: 6 of 34 claims left, 28 set aside
• USS Forrestal: 7 of 25 claims left, 18 set aside
• Dover Air Force Base: 8 of 17 claims left, 9 set aside
• Fort Belvoir: 9 of 17 claims left, 8 set aside
• Parris Island Marine Corps Recruit Depot: 9 of 15 claims left, 6 set aside
• Travis AFB: 10 of 25 claims left, 15 set aside
• Fort Sam Houston, Texas: 14 of 18 claims left, 4 set aside
• Camp Casey: 7 of 148 claims left, 141 set aside
• Camp Humphreys: 0 of 22 claims left, 22 set aside
• Camp Kinser: 0 of 15 claims left, 15 set aside
• Camp Page, Korea: 3 of 32 claims left, 29 set aside
• Camp St. Barbara: 1 of 16 claims left, 15 set aside
• Edgewood Arsenal, Maryland: 3 of 15 claims left, 12 set aside
• Eglin AFB, Florida: 10 of 34 claims left, 24 set aside
• Fort Chaffee, Arkansas: 1 of 19 claims left, 18 set aside
• Fort Clayton, Panama: 2 of 15 claims left, 13 set aside
• Fort Rucker: 10 of 17 claims left, 7 set aside
• Fort Sherman, Panama: 0 of 16 claims left, 16 set aside
• Kadena AFB: 1 of 86 claims left, 85 set aside
• Kadena Air Force Base, Okinawa, Japan: 1 of 74 claims left, 73 set aside
• Kimpo Air Force Base: 1 of 26 claims left, 25 set aside
• USS America: 8 of 43 claims left, 35 set aside
• USS Bennington: 1 of 16 claims left, 15 set aside
• USS Constellation: 7 of 59 claims left, 52 set aside
• USS Enterprise: 11 of 42 claims left, 31 set aside
• USS Franklin D. Roosevelt: 3 of 16 claims left, 13 set aside
• USS Hancock: 1 of 20 claims left, 19 set aside
• USS Independence: 5 of 17 claims left, 12 set aside
• USS Intrepid: 1 of 17 claims left, 16 set aside
• USS Kitty Hawk: 8 of 39 claims left, 31 set aside
• USS Oriskany: 2 of 20 claims left, 18 set aside
• USS Saratoga: 7 of 18 claims left, 11 set aside

Read the decisions

Recent decisions, with the Board's reasoning as summarized by AI:

• A25105794, December 2025: hypertension granted secondary to service-connected PTSD; a private medical opinion explained that the PTSD led to a sedentary lifestyle and metabolic changes that caused the hypertension.
• A25107192, December 2025: hypertension granted secondary to PTSD; the Board found the VA opinion inadequate because it did not separate the effects of PTSD and anxiety on blood pressure, and resolved the doubt in the veteran's favor.
• A25098215, November 2025: hypertension granted secondary to service-connected type II diabetes, supported by private medical opinions.
• A25111028, December 2025: hypertension denied; there was no evidence of it in service or within a year of separation, the first diagnosis came a decade later, and a VA examiner found no link to service.

What the data cannot tell you

The counts follow the diagnostic code, so they include some heart claims coded under DC 7101. Secondary counts include only claims the Board marked as secondary to a condition. The groups come from what each decision mentions; a mention is not proof of service or exposure. Historical outcomes, not predictions.

For representatives

• Gather readings from three different days before anything else; the diagnosis depends on them.
• For a secondary claim, get an opinion on the veteran's own history that addresses aggravation as well as causation.
• For a herbicide-exposed veteran, file under the PACT Act presumption first; no medical link is needed.
• After the grant, screen for heart, kidney and erectile dysfunction claims secondary to it.