How to take your blood pressure at home, step by step

Taking your blood pressure at home is easy once you know the routine. Sit down, rest for five minutes, put the cuff on your bare upper arm, and take two readings a minute or two apart. The details below come from the European Society of Cardiology's 2024 guideline, which asks people measuring at home to prepare the same way a clinic would.¹

Before you start

The guideline asks you to avoid these for at least 30 minutes before you measure:²

• exercise
• caffeine, such as coffee
• smoking

If you need the loo, go first. The guideline mentions an empty bladder too.²

Step by step

1. Pick a quiet spot.¹ A chair with a back, next to a table, works well.
2. Sit comfortably with your back against the chair and your legs uncrossed.²
3. Bare your upper arm. Take the sleeve off rather than rolling it up. A rolled-up sleeve can squeeze your arm like a tight band.²
4. Put the cuff on your upper arm, with its lower edge a few centimetres above the crease of your elbow.³
5. Rest your arm on the table so the cuff sits at the level of your heart. Your arm should be supported, not held up by you.³²
6. Rest for five minutes. Just sit. No phone calls, no getting up for the post.¹
7. Take two readings, one to two minutes apart.¹
8. Write both down straight away, with the date and time.

That's one session. Keep the routine the same every time. The guideline notes that the circumstances of a reading, such as your position, the technique and the accuracy of the monitor, affect the result, and asks for a consistent approach at home.²¹

Sitting or lying down?

Sitting. Plenty of people ask this, and the guideline's routine is clear: seated comfortably, back supported, arm supported, after five minutes of rest.² Keep to the same position every time.

How often, and for how long

When your doctor asks for a series of home readings, the guideline describes a simple pattern:¹

• twice a day, in the morning and in the evening, at the same times each day
• two readings each time, one to two minutes apart
• for at least three days, ideally seven

Morning readings are taken before breakfast, but not the moment you wake up.¹ At the end of the series, all the readings are averaged.¹ Your doctor is the one to tell you what your own numbers mean.

Easy things to get wrong

Most mix-ups are small and easy to fix once you know them:

• Measuring straight after the stairs or a coffee. Give it at least 30 minutes.²
• Cuff over a sleeve, or a sleeve pushed up tight. Bare arm, sleeve off.²
• Arm hanging down or held in the air. Rest it on the table, cuff at heart level.³²
• Crossed legs, or perched on the edge of the sofa. Sit back, legs uncrossed.²
• Skipping the five minutes' rest. It feels long. Use it to sit and do nothing.¹
• Taking one reading and stopping. The routine is two, one to two minutes apart.¹

The right cuff

The cuff matters more than most people expect. One that's too small pushes the reading up, and one that's too big pulls it down.³ Many cuffs have a size guide printed on them, so check that your arm falls inside the marked range.³ If it doesn't, ask at the pharmacy about a different cuff size for your monitor.

The right monitor

For home use, the usual choice is an upper-arm cuff monitor.¹ The guideline asks for one that has been clinically validated, meaning tested for accuracy, and notes that only a small share of the monitors on sale (as few as 6%) have been properly tested.⁴ National and international organisations publish lists of validated monitors; STRIDE BP (stridebp.org) is one the guideline names.⁴

Monitors don't last forever either. The guideline says to ask your doctor or nurse to check your monitor's accuracy from time to time, and notes that devices older than four years may be inaccurate.⁵

Keep your log in BePal

The guideline asks people measuring at home to keep a record of their readings and to take it to their doctor.⁵ BePal is our iPhone diary for keeping this kind of log. Add a reading in a few taps, and note coffee, alcohol, sugary drinks, sleep, exercise and weight next to it. Everything sits on one timeline, so you arrive at your appointment with tidy readings you can show your doctor on your phone.

The app is coming soon to iPhone.

Wherever you keep it, write down every reading you take. For each session, note:

• the date and time
• both readings, top and bottom number for each (and the pulse, if your monitor shows it)
• anything unusual, like a bad night's sleep or a missed rest

Keep it plain and honest. A complete, tidy record is what makes it useful when you sit down with your doctor.