Table II.

Summary of Recommendations for HBPM

Procedure	Recommendation
Technical aspects of BP measurement	Measure BP:
	• No tobacco or caffeine for 30 minutes preceding measurement
	• After 5 minutes rest
	• With arm at heart level; back supported and feet flat on the ground
	• On nondominant arm (or arm with the highest BP)
BP monitor	• Use a fully automated device with an upper arm cuff that has been validated by BHS, AAMI, or International Protocol for the Validation of Automated BP Measuring Devices
	• Monitors with memory that are able to store measurements are preferred
Training of patients	• Patients should be trained by their health care provider, and the monitor readings checked against mercury
	• Education content: hypertension and cardiovascular risk, BP measurement procedure, use of a validated monitor, cuff size, protocols for measuring BP, interpretation of BP readings, and monitor for their use only
	• Reevaluate patient technique and the accuracy of the device annually
Target BP goal	• 135/85 mm Hg, or 130/80 mm Hg if patient has diabetes, coronary heart disease, or chronic kidney disease (Class IIa; Level of Evidence B)
Frequency and schedule of measurement	Initial values (when patients begin HBPM):
	• Base decisions on a 7‐day measurement period with 2–3 measurements each morning and 2 to 3 measurements in the evening at prestipulated times (an average of 12 morning and evening measurements)
	• Exclude first‐day measurements from the analyses; take average of these values as the reference parameter in the subsequent dose‐titration phase
	Dose‐titration phase (titration of initial dose and adjustment of therapy):
	• All measurements should be made under identical conditions and at the same times of day as the initial values
	• HBPM data should be ascertained as trough values (ie, before medication is taken) in the morning and again at night
	• Use the average of BPs measured over 2 to 4 weeks to assess the effect of treatment
	Long‐term observation:
	• For stable normotensive (controlled) patients, patients should conduct HBPM a minimum of 1 week per quarter (an average of 12 morning and evening measurements under conditions described above)
	• Measurement should be made more frequently in patients with poor compliance
Abbreviations: AAMI, Association for the Advancement of Medical Instrumentation; BHS, British Hypertension Society; BP, blood pressure; HBPM, home blood pressure monitoring.