Use an upper-arm cuff blood pressure measurement device that has been validated and ensure that the device is calibrated periodically. 2. Support the patient s arm (e.g., resting on a desk) at heart level; the patient should not be holding his/her arm because isometric exercise will affect the blood pressure levels. 3. Position the middle of the cuff on the patient s upper arm at the level of the right atrium (midpoint of the sternum). 4. Use the correct cuff size such that the bladder encircles 75%-100% of the arm. 5. Use either the stethoscope diaphragm or bell for auscultatory readings. Step 3: Take the proper measurements needed for diagnosis and treatment of elevated blood pressure/HTN 1. At the first visit, record blood pressure in both arms. Use the arm that gives the higher reading for subsequent readings (if consistently 10-15 mm Hg higher). 2. Separate repeated measurements by at least 30 seconds. 3. For auscultatory determinations, use a palpated estimate of radial pulse obliteration pressure to estimate SBP. Inflate the cuff 20-30 mm Hg above this level for an auscultatory determination of the blood pressure level. Step 4: Properly document accurate blood pressure readings 1. Record SBP and DBP; if using the auscultatory technique, record SBP and DBP as the onset of the first of at least 2 consecutive beats and the last audible sound, respectively. 2. If using the auscultatory technique, record SBP and DBP to the nearest even number; if oscillometric, record reading displayed (or average displayed). 3. Note the time that the most recent blood pressure medication was taken before measurements. Step 5: Average the readings Use an average of 2 readings obtained on 2 occasions to estimate the patient s blood pressure. If fully automated oscillometric technique, manometer should display average of 2-3 readings. 