Printable Blood Pressure Journal

Per AHA/ACC (2017, Hypertension, 71(6)): Normal <120/80 mmHg; Elevated 120–129/<80; Stage 1 hypertension 130–139/80–89; Stage 2 ≥140/90. Hypertensive crisis >180/120 requires immediate medical attention. Record both systolic and diastolic in their respective columns. NHS UK uses slightly higher thresholds; follow your physician's targets, which may differ for diabetes, kidney disease, or age.

AHA (2019, Hypertension, 73(5)) and ESC guidelines recommend averaging 2 readings because the first is often elevated from brief sympathetic activation. Sit quietly 5 minutes before measuring. Record the average of both readings, or note both and average them later. Relying on single readings can overstate your blood pressure and lead to misleading conclusions about whether you need treatment.

AHA technique: sit with back supported, feet flat, arm resting at heart level, cuff on bare upper arm sized correctly (bladder covers 80% of arm circumference). No talking, caffeine, exercise, or smoking 30 minutes prior. Empty bladder first. The period and time columns let you keep consistent morning and evening timing — usually within an hour of waking and before bed.

Blood pressure follows a daily rhythm: it typically rises in the morning and falls during sleep. People whose pressure does not dip at night (non-dippers) have higher cardiovascular risk. Morning readings before medication assess overnight control; evening readings show daytime effects. The period column captures this — your cardiologist needs both to evaluate medication timing and dosing.

NICE advises taking two readings in the morning and two in the evening for at least four and ideally seven days, discarding the first day's readings, which are often elevated, and averaging the rest. A full week of twice-daily readings gives a reliable baseline, and the journal's 15-row pages fit a week of morning and evening entries. Bring them to every appointment — home readings often differ meaningfully from office measurements (white coat effect).

White coat hypertension — elevated office readings but normal home readings — is common, and without home monitoring it can lead to unnecessary medication. Conversely, masked hypertension (normal office, elevated home) is missed without tracking. Home journal data over 7+ days, paired with ambulatory monitoring when your doctor recommends it, as ACC/AHA guidelines suggest for these cases, separates these patterns and informs accurate diagnosis.

AHA hypertensive crisis criteria: systolic ≥180 or diastolic ≥120 mmHg. With symptoms (chest pain, shortness of breath, vision changes, severe headache, neurological symptoms), this is a hypertensive emergency requiring immediate ER evaluation. Without symptoms (hypertensive urgency), wait 5 minutes, re-measure; if still elevated, contact your physician same-day. Document symptoms in the symptoms column.

Log medication name, dose, and timing in the medication taken column. Many blood pressure medicines take a few weeks to show their full effect, so compare averages from the week or two before a medication starts or a dose changes with averages several weeks after. The pulse column also matters — beta-blockers reduce both BP and heart rate; ACE inhibitors mainly affect BP. Share trends with your cardiologist for dose optimization.