My Home Blood Pressure Log Template

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My Home Blood Pressure Log
My target home blood pressure is less than
/
mm/Hg. I use my
Right
Left arm
_______________
_______________
Systolic / Diastolic
REST for 5 minutes before taking the first blood pressure reading (#1).
WAIT 1 minute before taking the second blood pressure reading (#2).
MEASURE before taking your blood pressure medication & before eating or 2 hours after eating.
TAKE your blood pressure 10 to 12 hours apart when doing AM & PM measurements.
READ “Measure Blood Pressure at Home” for more information about proper home blood pressure
measurements techique at
DISCARD the readings of the first day and do the average of the last 6 days.
BRING your log and your medications to every appointment with your healthcare professional.
Heart Rate
BP Reading #1 (mmHg)
BP Reading #2 (mmHg)
DATE
TIME
COMMENTS
(beats per minute)
Systolic
Diastolic
Systolic
Diastolic
Meds at 9 AM
138
82
135
80
8:00 AM
Sample Morning
June 15
Upset
157
92
154
90
8:00 PM
Sample Evening
Day 1 Morning
Day 1 Evening
Day 2 Morning
Day 2 Evening
Day 3 Morning
Day 3 Evening
Day 4 Morning
Day 4 Evening
Day 5 Morning
Day 5 Evening
Day 6 Morning
Day 6 Evening
Day 7 Morning
Day 7 Evening
Average
day 2 to day 7

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