The seven-day home week
On this page
Take two measurements every morning and two every evening for seven days, then average all 28. The AHA lays it out this way, and it gives you one number you and your doctor can use.
If you have chest pain, shortness of breath, back pain, weakness, numbness, vision change or trouble speaking, stop the protocol and call emergency services, whatever the number.
At a glance
| Goal | One blood pressure average you and your doctor can trust |
| Fits | Any adult with a home cuff who wants a starting number, is following up on a clinic number, or wants to check for a white-coat or masked pattern |
| Length | 7 days, repeatable |
| Daily time | About 7 minutes, twice a day |
| What you need | A validated upper-arm cuff in your size, a chair, a table and a way to log |
The guidelines give this as general information, and it doesn’t change any treatment you’re on.
The steps
| Step | What to do | Where it comes from |
|---|---|---|
| Before day 1 | Measure around the middle of your upper arm and match it to your cuff with the cuff size tool. Check the exact model against a validated list. How to track covers this | AHA 2019 cuff table and validated device advice |
| Before day 1 | Measure both arms once. Use the higher arm for the whole week | AHA 2019 |
| Each session, first | Skip caffeine, smoking and exercise for at least 30 minutes, and empty your bladder | AHA 2019 |
| Each session, setup | Sit for at least 5 minutes with your back supported and feet flat. Rest your bare arm on a table with the cuff at heart height. Don’t talk or text | AHA 2019 |
| Days 1 to 7, morning | Take 2 measurements, 1 to 2 minutes apart | AHA 2019 |
| Days 1 to 7, evening | Take 2 measurements, 1 to 2 minutes apart, before bed | AHA 2019 |
| If you take blood pressure medication | Measure before your morning dose, then take it as prescribed. Keep taking every dose | AHA 2019 |
| Day 7 | Average all measurements with the home average tool | AHA 2019 |
| After day 7 | Compare the average against the home lines below. Take the sheet to a doctor if it’s 130/80 or higher | AHA 2019 |
The first day
The AHA statement lets you drop day 1, and then the preferred week is 8 days, with 4 as the minimum. If you drop it, write that on your sheet and do the same in later weeks.
If you miss a session
Keep going. Days in a row are best, but days with gaps still count. The AHA statement sets 3 days and 12 measurements as the minimum.
Comparing the average
| Home average | US guideline |
|---|---|
| Under 120/80 | Normal |
| 120 to 129 and under 80 | Elevated |
| 130 to 134 or 80 to 84 | Stage 1 |
| 135/85 or higher | Matches 140/90 in a clinic |
The guideline uses these lines for an average only, and never for a single measurement. For the two most common pairs, see 130/80 and 140/90.
How you know it worked
The week counts once you have at least 3 days of paired morning and evening measurements, and ideally all 7, taken with the same cuff and arm.
A single week still isn’t exact. Researchers looked at 163 people and found that a week of home measurements was the most repeatable of the methods they tested. It got the average within about 8 to 10 mmHg of the true figure, with 80 percent confidence (Warren 2010).
- To test a change, repeat the same week once the change has had time to work, and compare the two averages. How to lower your blood pressure lists how long each one takes.
- Don’t worry about a small change. A few points between two weeks may just be normal ups and downs, but a change that holds over several home weeks is more likely real.
- Keep it separate from clinic numbers. Don’t mix them into the same average.
Who should not follow it
- Anyone with chest pain, shortness of breath, back pain, weakness, numbness, vision change or trouble speaking. Call emergency services now, and leave the week for later.
- Anyone whose systolic (the top number) hits 180 or more, or diastolic (the bottom number) hits 120 or more, during the week. Rest five minutes and measure again. If it stays that high, call your doctor the same day, and don’t wait for day 7.
- Anyone pregnant or recently pregnant. Follow the schedule and thresholds from your care team. After 20 weeks, call them if you get 140/90 or higher on two checks at least 4 hours apart. If you get 160/110 or higher, or a severe headache or vision change, get care right away.
- People with atrial fibrillation or another irregular pulse. Ask your doctor first. The AHA statement says automatic cuffs give a valid systolic number in atrial fibrillation, but the diastolic is less accurate.
- Anyone told by their doctor to follow a different schedule. Their schedule comes first.
When to see a doctor after the week
Book a visit if the average is at or above 130/80, if your clinic and home numbers disagree, or if you feel faint or dizzy when you stand up. Under the 2025 US guideline, home monitoring helps confirm a clinic diagnosis, so bring the full sheet along with the average.
5 sources
- Muntner et al., Measurement of Blood Pressure in Humans, AHA scientific statement, Hypertension, 2019pmc.ncbi.nlm.nih.gov
- Warren et al., variability of office, ambulatory and self-monitored blood pressure, British Journal of General Practice, 2010pmc.ncbi.nlm.nih.gov
- ACC, New high blood pressure guideline press release on the 2025 AHA/ACC guideline, 2025acc.org
- American Heart Association, When to call 911 about high blood pressureheart.org
- ACOG Practice Bulletin 222, as summarized by AAFP, 2019 practice bulletin summaryaafp.org
