Daily Blood Pressure Monitoring Schedule
Take blood pressure measurements twice daily—once in the morning (before breakfast and medications, but not immediately after waking) and once in the evening—with two readings per session separated by 1-2 minutes, for a minimum of 3 days and ideally 7 days. 1
Specific Timing Protocol
Morning Measurements
- Timing: Before breakfast and before taking any medications 1, 2
- Important caveat: Not immediately after awakening—allow some time after getting up 1, 2
- Number of readings: Take 2 readings, 1-2 minutes apart 1
Evening Measurements
Preparation Before Each Measurement Session
Critical 30-minute restrictions 2, 3:
- Avoid caffeine
- Avoid tobacco
- Avoid vigorous exercise
Immediate pre-measurement steps 1, 4:
- Empty bladder
- Rest quietly for 5 minutes while seated
- Sit with back straight and supported
- Keep feet flat on floor, legs uncrossed
- Position arm at heart level on a flat surface
- Remain silent during measurement
Duration of Monitoring
Initial Assessment
- Minimum: 3 consecutive days 1, 5
- Ideal: 7 consecutive days 1, 6
- Key detail: Discard all readings from the first day 1, 6, 4
- This provides 12-24 total readings for analysis (excluding day 1) 1
During Medication Adjustment
- Continue same measurement schedule for 2-4 weeks to assess treatment effect 6
- Maintain identical measurement conditions and times as baseline 6
Long-Term Monitoring (Stable Patients)
- Repeat the 7-day protocol at least once per quarter (every 3 months) 6
Data Recording and Analysis
- Use a device with memory storage to avoid reliability issues with manual diaries 1, 4
- Calculate the average of all readings excluding the first day 1, 4
- Record all measurements—do not cherry-pick readings 1
Interpretation Thresholds
- Hypertension: Average home BP ≥135/85 mmHg 1, 4
- Elevated BP: 120-134/70-84 mmHg 1, 4
- Normal BP: <120/70 mmHg 1
Common Pitfalls to Avoid
Do not include first-day measurements in your average—these show greater variability and should be excluded from analysis 1, 6, 4. This is a critical error that can lead to inaccurate BP assessment.
Avoid measuring immediately after waking—allow time for the body to stabilize after rising 1, 2. The morning surge in BP immediately upon awakening does not represent your typical morning pressure.
Do not become obsessive about checking BP outside the recommended schedule 1. Some patients develop anxiety from frequent checking, which paradoxically raises BP and creates a vicious cycle. If this occurs, reduce measurement frequency or discontinue home monitoring 1.
Ensure proper technique annually by bringing your device to clinic visits for accuracy verification and technique review 1, 6. Devices older than 4 years may become inaccurate and should be replaced 1.