While states impose health regulations on who can drive a commercial vehicle, most do not specify which heart conditions may affect driving safety and do not regulate private drivers. Still, it is estimated that heart conditions may be responsible for up to 88% of driver deaths due to natural causes, or about 2% of all driving fatalities.

The American Medical Association has issued guidelines on driving and heart disease. As you can see from the Table, most people with hypertension and heart disease can continue to drive safely.

Condition	Recommendation
Controlled hypertension; hypertension without symptoms	OK to drive without restriction
Coronary artery disease without symptoms or with negative findings on angiography, nuclear stress test, or stress echocardiography	OK to drive without restriction
Occasional heart palpitations	OK to drive without restriction
Hypertension with vertigo, faintness, loss of consciousness, lack of alertness, easy fatigue	Waiting period necessary to observe, investigate, or treat
Loss of consciousness	Waiting period necessary to observe, investigate, or treat
Recent coronary angioplasty, bypass surgery, heart attack, or unstable angina	Waiting period (3 months to a year) necessary to observe, investigate, or treat
Pacemaker implantation	Waiting period necessary to observe, investigate, or treat

Source:  On the road with heart disease. Heart Watch. September/October 2000.