Heart Conditions Secondary to Hypertension

The recognized connection, the three-legged evidence standard, and the free routes to the medical opinion.

← All secondary claims · Ratings by condition

A secondary claim is a condition caused or worsened by one the VA has already service-connected. The causation fight is already half-won — the VA agreed your hypertension came from service; the question is only whether it caused the heart conditions. That's a medical question with a recognized answer.

The connection

Untreated or long-standing high blood pressure damages the heart and vessels — hypertensive heart disease, and elevated stroke risk, follow it. Notably: when hypertension is service-connected and a stroke comes later, VA guidance directs raters to treat the stroke as presumptively secondary. If you are an HTN-rated veteran who has had a stroke or TIA, that is a claim, and an active stroke rates at 100%.

How the VA rates heart conditions

METs-based: 60% = workload of 3–5 METs causes symptoms · 30% = 5–7 METs · 10% = 7–10 METs. 100% for chronic CHF. Documented cardiac event or procedure rates on residuals.

Full criteria and evidence guide: VA rating for heart condition.

What the claim needs — the three legs

  1. The anchor: service connection for the hypertension (see how that condition is rated). Not connected yet? File it first — a secondary claim needs something to attach to.
  2. A current diagnosis of heart conditions — the VA rates diagnosed conditions, not symptoms.
  3. The medical link. An opinion stating it is "at least as likely as not" that the hypertension caused or aggravated the heart conditions. The VA's own C&P examiner supplies this free in most cases; your own doctor can too. A paid independent opinion is the last resort, not the first move.
Honesty note: nothing here is a promise of any rating — the VA decides every claim on its own evidence. What this page describes is a recognized medical pathway and the evidence standard that applies to it. Describe your real symptoms, including your worst days, accurately — never more, never less.

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