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Hit points, also known as health points (or HP), damage points, or just health (among other synonyms), is a finite value used to determine how much damage (usually in terms of physical injury) a character can withstand. When a character is attacked, or is hurt from a hazard or fall, the total damage dealt (which is also represented by a point value) is subtracted from their current HP. Once their HP reaches 0, the character will fall unconscious and be unable to fight. In DDO, health is often abbreviated by two letter initialisms such as HP.
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In DDO, player characters and hirelings do not die until they reach -10 hit points or lower. Getting reduced to anywhere from 0 to -9 renders you merely unconscious and dying. If you are dying, you lose 1 hp every ten seconds from blood loss until either you die or you stabilize, in one of three ways:
- Another character can heal you or grant you temporary hit points with any usual spell, item, or ability. Incapacitated Warforged characters can also be rescued with magical repair. This healing has to offset your negative hit points first. Once you rise to 1 hp or greater, you become conscious again (and stop bleeding).
- Another character can attempt to use the Heal skill on you. This uses up a healing kit. On a successful skill check, this immediately makes you conscious again and sets your hp to 1. Failure only uses up the kit. Warforged characters must be rescued with repair kits and the Repair skill instead.
- There is a 10% chance every time you would bleed that you become stable on your own. You don't recover instantly, however. There is a brief delay, then you begin recovering 1 hp per 6-second round instead of bleeding. You don't become conscious until you reach 1 hp. Warforged characters and characters with the Diehard feat stabilize automatically, but they still go through this recovery process. A proc from an item with regeneration will also trigger a stabilization.
Incapacitated characters are still vulnerable to attacks and to damage. They can easily die from getting caught in area attacks or from enemies that deliberately keep attacking them once they're down.
An unconscious character cannot move or take any actions.
 Increasing Hit Points
Hit points increase by themselves when you level up. That increase is not equal for everyone and depends on many factors. However, everyone benefits from the bonus 20 HP from the free Heroic Durability feat received at creation.
For each level, you gain hit points depending on the class you take that level in.
On each level, your Constitution modifier is modified according to your level*mod and added to your hp. This is no static value and may change according to how your modifier changes because of buffs and debuffs on your constitution; negative modifiers count as 0.
At level 20, it is 20 hp per 2 constitution over 10 constitution. For example 22 con at level 20 gives you 6*20 hp for a total of 120 hp. ((22-10)/2)*20
 Toughness Feat
 Toughness Enhancements
After taking the Toughness feat, you may increase its benefits by taking the Toughness Enhancement. There are 2 lines of Toughness enhancements, one from race and one from class, both of which stacks. Toughness enhancements from taking multiple classes, however, do not stack. Each toughness enhancement line can go up to a maximum of 4 tiers (+10 hit points per tier), the actual limit depending on the chosen race/class.
- Racial Toughness Enhancements Access up to 4 tiers: Dwarf, Warforged
- Racial Toughness Enhancements Access up to 3 tiers: Human, Half-Elf
- Racial Toughness Enhancements Access up to 2 tiers: Drow, Elf, Halfling, Half-Orc
For class toughness enhancements, refer to the enhancements section for details.
 Other bonuses
- Characters can get +10 hp from Draconic Vitality, received by achieving 150 Agents of Argonnessen favor.
- Characters can wear gear with properties from the False Life line of enchantments, for +5/10/20/30/40 hp.
- Certain prestige enhancements grant a hit point bonus, e.g. Bard Warchanter II, Artificer Battle Engineer I, Fighter Stalwart Defender, or Paladin Defender of Siberys.
- Toughness item enchantment gives +20 hp that stacks with all other bonuses.
- Green Steel accessories can give +10/15/20 hp for a total of +45 hp across the three tiers (Elemental Energy). Greater Elemental Energy (+20 hp) can also be found on the Alchemist's Pendant and certain sets of Dragontouched Armor (with a Sovereign Rune of Health added).
- A guild augment Crystal of Health stacks for an additional +5/10/15/20 hp, depending on size.
- Constitution item enchantments (called Health on random gear).
- Note that items that increase your hit points directly (as opposed to increasing your Constitution) don't automatically give them to you; they merely increase the maximum possible. There will still be a hole left until you get some healing to top it off. These same items will also take the extra hp "off the top" if removed. Changes to your Constitution will indirectly, and immediately, increase (or decrease) your hp. In other words, a level 20 character with 480 hp who equips a Toughness item will be at 480/500 hp, while the same character who increases his Constitution by 2 points will be at 500/500 hp. Later, the same character removing the items while at 480/500 hp will then be at 480/480 after removing the Toughness item, or 460/480 after reducing his Constitution.
 Temporary Hit Points
Some effects award a character additional, special hp called temporary hit points. Any damage the character suffers that would normally affect his real hp applies to his temporary hp first. As their name implies, they don't last forever -- only until they're used up or the buff that granted them wears off. Temporary hp appear as a number with a "+" sign, in parentheses, after the character's real hp count on top of his red hp bar.
Bonuses and penalties that affect healing amounts do not affect temporary hit point gains.
Some common effects that cause temporary hit points:
- Aid/Mass Aid: +9-18 hp for Aid, +9-23 hp for Mass Aid, depending on the level of the spell.
- Greater Heroism: +11-20 hp, depending on the level of the spell.
- Life Shield: +15 hp for one minute.
- Bodyfeeder: +15 hp for one minute.
- Demonic Shield: +30 hp.
- Concordant Opposition +30 hp.
- A bard's Inspire Greatness song: +20 hp.
- False Life spell - +13-20 hp. Note that this stacks with the more permanent False Life item enchantment.