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Blood Pressure Log

NameTarget

Readings

Date

Time

Systolic (top)

Diastolic (bottom)

Pulse

Arm / Position

Notes

※ For personal record-keeping only — this log is not medical advice. Share it with your doctor or pharmacist, and follow their instructions and how often to measure. If a very high reading comes with chest pain, shortness of breath, weakness or vision changes, call 911.

How to fill out a Blood Pressure Log

Blood Pressure Log template preview — Free Blood Pressure Log template

A simple record of your home blood pressure readings to bring to appointments. Each of the 24 rows has the date, time, systolic (top number), diastolic (bottom number), pulse, which arm or position you used, and notes. It is a record-keeping sheet only and is not medical advice.

How to fill it out

Write your name at the top, and the target range your doctor gave you if you have one.
Measure at the times your doctor recommends and write the date and time of each reading.
Record the systolic (top) and diastolic (bottom) numbers and your pulse from the monitor.
Note the arm or position and anything relevant, such as medication taken or symptoms.
Bring the printed log, or a PDF, to your next appointment.

Tips

Follow your doctor’s instructions on when and how often to measure.
Many home-monitor instructions recommend sitting quietly for a few minutes first, with feet flat and your arm supported at heart level.
Use the same arm each time unless told otherwise, and write it down.
This log is not medical advice. If a very high reading comes with symptoms such as chest pain or shortness of breath, call 911.

Blood Pressure Log example

Name: Robert Miller
Target: Per Dr. Patel

Readings

10/12 · 7:15 AM · 128 · 82 · 70 · Left · seated · Before meds
10/12 · 8:30 PM · 124 · 80 · 68 · Left · seated
10/13 · 7:10 AM · 131 · 84 · 72 · Left · seated · Slept poorly
10/13 · 8:45 PM · 122 · 79 · 66 · Left · seated
10/14 · 7:20 AM · 126 · 81 · 69 · Left · seated · Before meds

All names, companies and contact details are fictional. Click “Fill sample” above to put this example into the empty fields; click again to remove the parts you did not change.

FAQ

Which number is systolic and which is diastolic?

Systolic is the top (first, larger) number on your monitor; diastolic is the bottom (second) number. Pulse is shown separately in beats per minute.

Can I fill in the log on my computer?

Yes. Type your readings and save or print a PDF to share with your doctor. Your data stays only in your browser.

Is this blood pressure log medical advice?

No. It is only a place to record readings. Ask your doctor or healthcare provider what your readings mean and what your target should be.

Related templates

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