Blood Pressure Review

 
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Blood Pressure

Take a reading in the Morning and Evening

  • Sit quietly for 5 mins
  • Take two readings more than one minute apart whilst seated
  • Record the second of the two readings below
Your 1st set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
Do you need to add a 2nd set of Readings: *
All sets of readings must be added consecutively
Your 2nd set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
Do you need to add a 3rd set of Readings: *
All sets of readings must be added consecutively
Your 3rd set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
Do you need to add a 4th set of Readings: *
All sets of readings must be added consecutively
Your 4th set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
Do you need to add a 5th set of Readings: *
All sets of readings must be added consecutively
Your 5th set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
Do you need to add a 6th set of Readings: *
All sets of readings must be added consecutively
Your 6th set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
Do you need to add a 7th set of readings: *
All sets of readings must be added consecutively
Your 7th set of Readings
 
Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Your pulse rate is the number of times your heart beats per minute
Top Number
Bottom Number
Pulse
 

If you need to submit further readings, please complete another form.

  
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Confirmation

Confirm your readings

You are submitting  separate sets of readings

  • Please return to the previous page to make any corrections

1st set of readings 

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate

2nd set of readings: 

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate

3rd set of readings

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate

4th set of readings

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate

5th set of readings

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate

6th set of readings

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate

7th set of readings

Date: 

yyyy-mm-dd

  Morning Evening
Systolic
Diastolic
Heart Rate
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Health Questions
What is your smoking status?: *
Are you diabetic?: *
Diabetic patients and those 80 years and over

If you are diabetic, 80 years and over or almost 80 we would like to check that your blood pressure does not drop significantly when you stand.

  • In addition to the readings above, please can you also take your blood pressure whilst sitting, and then repeat this again 1 minute after standing-up.
  • Please stay standing if possible and repeat again 3 minutes after you have stood up.
 

Blood pressure sitting

Your systolic blood pressure is the top number on your reading
Your diastolic blood pressure is the bottom number on your reading
Blood pressure after standing for 1 minute
Top Number
Bottom Number

Blood pressure after standing for 3 minutes

Top Number
Bottom Number
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