See the section on identifying who to refer for people with a clinic blood pressure 180/120 mmHg or higher. [2019] 1.2.4 If ABPM is unsuitable or the person is unable to tolerate it, offer home blood pressure monitoring (HBPM) to confirm the diagnosis of 1.2.5 While waiting for confirmation of a diagnosis of hypertension, carry out: investigations for target organ damage (see recommendation 1.3.3), followed by formal assessment of cardiovascular risk using a cardiovascular risk assessment tool (see the section on full formal risk assessment in NICE's guideline on cardiovascular disease). [2019] 1.2.6 When using ABPM to confirm a diagnosis of hypertension, ensure that at least 2 measurements per hour are taken during the person's usual waking hours (for example, between 08:00 and 22:00). Use the average value of at least 14 measurements taken during the person's usual waking hours to confirm a diagnosis of hypertension. [2011] 1.2.7 When using HBPM to confirm a diagnosis of hypertension, ensure that: for each blood pressure recording, 2 consecutive measurements are taken, at least 1 minute apart and with the person seated and blood pressure is recorded twice daily, ideally in the morning and evening and blood pressure recording continues for at least 4 days, ideally for 7 days. Discard the measurements taken on the first day and use the average value of all the remaining measurements to confirm a diagnosis of hypertension. [2011] 1.2.8 Confirm diagnosis of hypertension in people with a: clinic blood pressure of 140/90 mmHg or higher and ABPM daytime average or HBPM average of 135/85 mmHg or higher. 