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    Form - Blood Pressure Record Sheet

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    Tracking Your Blood Pressure

    Tracking Your Blood Pressure

    To take your blood pressure, you'll need a machine called a blood pressure monitor. You may be given one by your health care provider. You can also buy one at your clinic, drug store, or online. Do not choose a monitor that measures your blood pressure from your wrist or finger.

    When choosing a monitor, make sure it has:
    • An automatic monitor and an arm cuff.
    • A cuff that wraps snugly, but not too tightly, around your upper arm. You should be able to fit just one finger between your arm and the cuff.
    • A device that stores blood pressure reading results.
    Take your blood pressure as told by your provider. To use this form:
    • Ask your provider what your target or goal blood pressure is.
    • Get one reading in the morning (a.m.) before you take any medicines.
    • Get one reading in the evening (p.m.) before dinner or supper.
    • Take at least 2 readings with each blood pressure check. This makes sure the results are correct. Wait 1–2 minutes between readings.
    • Write down the results in the spaces on this form.
    • Repeat this once a week, or as told.
    • A person checking his blood pressure with a monitor and cuff.Make a follow-up appointment with your provider to talk about the results.

    Target blood pressure

    My target blood pressure reading is: _______________________

    Blood pressure log

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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