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Blood Pressure Management Tracking Log

Daily Blood Pressure Monitoring and Lifestyle Journal

Cardiology

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: ___________________ Date Started: //___ Primary Care Provider: ___________________

Daily Blood Pressure Readings

Instructions:

  • Take readings at the same time each day
  • Sit quietly for 5 minutes before measuring
  • Record both systolic (top) and diastolic (bottom) numbers
Date Time Systolic Diastolic Pulse Notes

Medication Log

Medication Name Dosage Time Taken Side Effects

Lifestyle Factors

Daily Exercise

  • Type of activity: ______________
  • Duration: ________________
  • Intensity (mild/moderate/vigorous): ________________

Dietary Tracking

  • Sodium intake (estimate): _______ mg
  • Fruits/Vegetables (servings): _______
  • Water intake (cups): _______

Weekly Summary

Average BP: / Missed medications: ___ Exercise sessions: ___

Emergency Contact Information

Doctor's Office: ________________ Emergency Contact: ________________ Call 911 if BP exceeds / or falls below /

Notes

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