, phones), and no one should speak with the patient during the rest period and readings After the five-minute rest period, push the button to initiate the first inflation/reading; record SBP and DBP reading Take the next reading(s) with at least a 30 second interval between readings and record SBP and DBP readings displayed for each reading; record the average or median SBP and average or median DBP as the patient s blood pressure For standard auscultatory technique with manual manometer: Use an upper-arm cuff manual device that has been validated and recently calibrated; this includes a mercury manometer, an aneroid manometer, or an electronic manual non-oscillometric manometer for auscultatory determinations Position the patient and place the proper sized cuff on the upper arm before initiating the wait time and blood pressure readings Patient should remain quiet and not use electronic devices (e.g., phones), and no one should speak with the patient during the rest period and readings Use a palpated estimate of radial pulse obliteration pressure (disappearance or resumption of pulse when cuff is inflated/deflated) to estimate SBP; inflate the cuff 20-30 mm Hg above this level to perform the auscultatory determination of the blood pressure level Use either the stethoscope diaphragm or bell for auscultatory readings After the five-minute rest period, inflate the cuff and use auscultation to determine SBP and DBP; determine SBP and DBP as the onset of the first of at least two consecutive Korotkoff sounds (beats) and the last audible Korotkoff sound, respectively Record the SBP and DBP reading Take the next reading(s) with at least a 30 second interval between readings and record SBP and DBP readings for each reading; record the average or median SBP and average or median DBP as the patient s blood pressure Appendix H: Guidance for Conducting Home Blood Pressure Measurement The following information has been adapted from the 2019 AHA Measurement of Blood Pressure in Patient training provided by healthcare staff or providers: Provide information about hypertension diagnosis and treatment Provide information on the proper selection of a device Provide instruction on how patients can measure their own blood pressure (if possible, demonstrate the procedure or instruct how to access training video) Provide instruction that the HBPM device and blood pressure readings (log or electronic recording) should be brought to healthcare visits Provide education that individual blood pressure readings may vary greatly (high and low) across the monitoring period Preferred devices and cuffs: Use an upper-arm cuff oscillometric device that has been validated Use a device that is able to automatically store all readings, if possible Use a device that can print results or can send blood pressure values electronically to the healthcare provider, if possible Use a cuff that is appropriately sized for the patient s arm circumference Table H-1. 