Hamstreet Surgery – Home Blood Pressure Monitoring

Name: 	Date: 	
DOB: 	Target BP: 	

Your doctor has provided you with this form because your blood pressure in the surgery is elevated OR you have agreed that your blood pressure readings are easier to monitor at home. Your target blood pressure is included above.

How to take your readings
You should use a blood pressure machine that fits around your arm (not your wrist). Your blood pressure will need to be monitored over 5 days. Start on the first day by taking your blood pressure in the morning when you are sitting quietly. Take three readings in a row. Do the same in the evening. The first day is a practice day only; you do not need to record any readings. From the second day onwards, repeat exactly what you did in the morning and evening on the first day, but this time you will need to write in the third reading from the morning and evening in the table below. The higher number is your systolic pressure. The lower number is your diastolic pressure. At the end of the 5 days (or 4 days of readings) you will need to calculate the average systolic and diastolic pressures using the grid below. 

	DAY 1	DAY 2	DAY 3	DAY 4	DAY 5		Average BP	
	AM	PM	AM	PM	AM	PM	AM	PM	AM	PM			
Systolic											Add numbers in this row and divide by 8		
Diastolic											Add numbers in this row and divide by 8		

Submitting the readings
Please return this form to reception. You can either bring it to the surgery or send it by email to KMCCG.hamstreetsurgery@nhs.net. Please arrange a routine telephone consultation with the requesting GP or nurse to discuss your readings, unless you have been advised otherwise.