Blood pressure at home is measured after resting, sitting with the back supported, with the arm at heart level and the feet flat on the floor. Sit quietly for at least five minutes before the measurement, and do not talk while it is being taken. Taking and recording two readings in the morning and two in the evening is advised.
High blood pressure often gives no symptoms. The World Health Organization (opens in a new tab) reports that, as of 2024, an estimated 1.4 billion adults aged 30–79 worldwide have hypertension, and that this corresponds to 33% of the population in that age range. The same source states that approximately 600 million of the people with hypertension (44% of them) are unaware of their condition.
For this reason, home readings complement the readings taken at the practice. The World Health Organization emphasises that the only way to detect hypertension is to have blood pressure measured by a health professional; home readings support that assessment but do not replace it.
The same body lists raised blood pressure (together with raised blood sugar, raised blood lipids and excess weight) among the intermediate risk markers for cardiovascular disease (opens in a new tab) that can be measured in primary care.
Preparation before the measurement
- Do not have tea or coffee, and do not smoke, in the 30 minutes before the measurement
- Go to the toilet before the measurement; a full bladder may affect the reading
- Do not take a reading immediately after exercise
- Rest by sitting quietly for at least 5 minutes
- Make sure the arm is free of tight clothing; taking the arm out of the sleeve is better than rolling the sleeve up
Step-by-step measurement
- Sitting position. Sit on a chair with your back supported. Do not cross your legs; keep your feet flat on the floor.
- Arm position. Rest your arm on a table so that it is supported at heart level. An arm held up in the air changes the reading.
- Cuff placement. Wrap the cuff about two fingers’ width above the bend of the elbow, neither too tight nor too loose.
- Silence. Do not talk or move while the measurement is being taken.
- Two readings. Wait 1–2 minutes after the first reading and then take the second. Record the average of the two readings.
- Recording. Write down the date, the time, the upper and lower readings and the pulse.
How often: Two readings twice a day, generally in the morning (before taking medication) and in the evening, are advised. Your physician determines how many days you should take the readings for.
Common mistakes
| Mistake | Why it is a problem |
|---|---|
| Not resting before the measurement | The reading may be falsely high |
| Holding the arm up in the air | Measuring below or above heart level changes the reading |
| Rolling up the sleeve and constricting the arm | Rolled-up fabric may act as a tourniquet |
| Talking during the measurement | It may raise the reading |
| Deciding on a single reading | A single reading does not show the fluctuation |
| Recording only the reading that comes out high | It misrepresents the course; all readings are written down |
| Using a wrist device instead of an upper-arm device | Wrist measurement is more prone to positioning errors |
| Changing medication on your own initiative according to the reading | This is dangerous; adjusting medication is a decision for the physician |
In which patients is it assessed differently?
In the situations below, the assessment proceeds differently.
- In pregnant patients (the follow-up interval and the cut-off values are different, and monitoring runs alongside antenatal follow-up)
- In patients with a heart rhythm disorder (automatic devices may measure incorrectly; the method of measurement is determined with the physician)
- In patients whose arm is very thin or very thick (the cuff size should be chosen appropriately)
- In patients who have had breast surgery, or who have a fistula or lymphoedema in the arm (the arm to be used for the measurement is determined with the physician)
- In patients over 65 (a fall in blood pressure on standing is assessed separately)
- In patients under 18 years of age (assessment lies within the field of paediatrics; this content has been prepared for adults)
Points to be aware of
A single high reading does not establish a diagnosis. A diagnosis of hypertension is made with readings taken on different days and with an assessment by a physician.
There may be a difference between the two arms. At the first assessment the measurement is taken from both arms; later readings continue on the arm that gives the higher reading.
Have the accuracy of your device checked. You can take your device to your follow-up appointment and ask for it to be compared with the reading taken at the practice.
Do not change your medication yourself on the basis of a reading. Increasing the dose, reducing it or stopping the medicine happens only on a physician’s decision.
Results vary from person to person.
When should you see a physician without delay?
If you notice these symptoms, consult a physician without delay:
- Home blood pressure readings that run persistently high
- Dizziness, blacking out or falling on standing up
- Readings that fall markedly while you are taking blood pressure medication
- High blood pressure in pregnancy
In the event of raised blood pressure accompanied by a severe headache or blurred vision, swelling of the hands and face added to raised blood pressure in pregnancy, chest pain, shortness of breath, disturbance of speech, drooping of the face or sudden loss of strength, go directly to the emergency department.
Frequently asked questions
How many times a day should I measure my blood pressure?
Two readings on each occasion, twice a day, generally in the morning and in the evening, are advised. Your physician determines how many days you should take the readings for and at what intervals to repeat them. Measuring frequently during the day may increase anxiety and does not contribute to the assessment.
Should I measure from the arm or the wrist?
Upper-arm devices are generally preferred; wrist measurement is more sensitive to the position of the arm and the wrist. Consult your physician about which device is suitable for you.
Should I measure in the morning before taking my medication?
You are generally asked to take the morning reading before your medication, so that it shows the point at which the effect of the medicine has worn off. However, this may vary according to the medicine you take. Follow the routine your physician has given you.
I get different readings from my two arms; which one is correct?
There may be some difference between the arms. At the first assessment the measurement is taken from both arms, and follow-up then continues on the arm that gives the higher reading. If there is a marked difference, this is assessed separately.
My blood pressure comes out high only at the practice; is that normal?
It is well recognised that readings taken at the practice can come out higher than home readings, and home records are requested for this reason. However, this is for the physician to assess; it is not simply assumed to be “unimportant”.
How should I record my readings?
Write down the date, the time, the upper reading, the lower reading and the pulse. If anything out of the ordinary happened before the measurement (a sleepless night, pain, a change of medication), note that as well. Bring the records to your follow-up appointment.
Sources
- World Health Organization, Hypertension fact sheet, 25 September 2025. https://www.who.int/news-room/fact-sheets/detail/hypertension (opens in a new tab)
- World Health Organization, Cardiovascular diseases (CVDs) fact sheet, 31 July 2025. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (opens in a new tab)
