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HBPM should be used (Figure 4). Patients should be counselled to follow the same preparation steps as used in clinics, which are outlined in Section 5.2.2. Two measurements should be taken at each measurement session, performed 1–2 min apart. Measurements should be made twice a day (morning and evening) at the same time for a minimum of 3 days and up to 7 days.59 At the end of the measurement period, all readings are averaged. If the average after 3 days is close to the treatment threshold, then measurement should continue for the full 7 days. Patients should be informed to keep a record of their home BP values and to ask their healthcare provider that the device accuracy be intermittently checked. Devices older than 4 years may be inaccurate and, if inaccurate, should be replaced.60

An average HBPM of ≥135/85 mmHg (equivalent to an office BP of ≥140/90 mmHg) should be used to diagnose hypertension and an average systolic BP of 120–134 mmHg or diastolic BP of 70–84 mmHg should be used to diagnose elevated BP. Of note, we use the same lower BP threshold (120/70 mmHg) for both office and HBPM in defining elevated BP.61

3

Home-based blood pressure measurement

1

Use a validated BP

device 2

Measure BP in a quiet room after 5 min of rest with arm

and back supported

Obtain two readings

on each occasion,

1–2 min apart

4

Obtain readings twice a day

(morninga and evening) for at least 3 and ideally 7 days

average HBPM ≥135/85 mmHg

Hypertension:

5

Record and average all

readings and present

results to clinician

Figure 4 Summary of home blood pressure measurement. BP, blood pressure; HBPM, home blood pressure measurement. aMorning HBPM readings should be obtained before breakfast and before intake of medication but not immediately after awakening. Downloaded from academic.oup.com/eurheartj/article/45/38/3912/7741010 by guest on 07 October 2026