BP measurements should be taken both in the morning

The gap

Evidence profile

Sourced from the recommendations and limitations of the source papers, classified as general, drawn from work published between 2024 and 2026, spanning 3 journals. Those papers have been cited 45 times in total.

Supporting evidence — 3 representative gaps

• Clinical practice guideline for the management of hypertension in China (2024) · Chinese Medical Journal · cited 45× · doi

  BP measurements should be taken both in the morning and evening. Obtain at least two consecutive BP readings each session, with a 1-min to 2-min interval between them. Calculate the average of these two readings; if the difference is greater than 10 mmHg, take a third reading and average the last two. Before measuring BP, refrain from exercise, alcohol, caffeine, and smoking for at least 30 min, and rest quietly for 3–5 min (1D). It is advised to measure BP before medication intake or breakfast and after emptying the bladder (1B). Evening BP measurements should ideally be taken before dinner; if not feasible, it is suggested to measure within an hour before bedtime (2D). For those newly diagnosed with hypertension or whose BP is uncontrolled, HBPM on at least three consecutive days weekly is recommended (1B). For individuals with well-regulated BP, HBPM can be performed once or twice a week (2D).

  generalrecommendationsevidence 5/5
  Keywords: least measurements taken evening consecutive readings average measure hbpm morning obtain session interval them calculate
• Preliminary data from the nationwide blood pressure control program in Poland in 2025 — MISSION 50/30 (2026) · Arterial Hypertension · doi

  Multiple BP measurements taken on a single oc- casion do not allow for the diagnosis of hypertension according to current guideline recommendations, as many such individuals may not have sufficiently elevated BP values to establish a definitive diagnosis of hypertension under these conditions. Therefore, confirmatory measurements on separate occasions are required, similar to repeated office BP assess- ments conducted over several visits. Furthermore, despite efforts to standardize BP measurement con- ditions, readings may have been influenced by ex- ternal factors specific to the circumstances in which measurements were performed, potentially affecting the accuracy of recorded BP values. In previous publications from the MMM pro- gram [8–10], the reported results included the individuals unaware of their proportion of 16 arterial hypertension 2026, vol. 30, e01826001www.ah.viamedica.plhypertension; thus, the hypertensive group in those studies comprised both participants with previously diagnosed hypertension and those without a prior diagnosis who met the criteria for hypertension during the measurements done on a single occasion in the survey. Accordingly, in the MMM reports, elevated BP values obtained from several measure- ments on a single occasion — with the average BP value consistent with the hypertension range — were accepted as a proxy indicator of hyperten- sion for the purpose of classifying participants as hypertensive or non-hypertensive. In contrast, the authors of the present report adopted a different approach. For comparison of the current results with previous MMM editions, only individuals with a self-reported history of hypertension were included, whereas those with “unawareness” of hypertension — who were clas- sified as hypertensive in the MMM publications [8–10] — were not included. As a result, the pro- portions presented in Table 5 for participants re- ceiving antihypertensive medications and for those with BP < 140/90 mm Hg in the MMM editions (2018, 2019, and 2021) were recalculated relative to the number of participants with a self-reported history of hypertension, rather than to the overall number of participants categorized as hypertensive in the original MMM reports. Due to the opportunistic nature of the study, the population assessed may not have been ful- ly representative of the general Polish population. It is likely that individuals most interested in their own health were more inclined to participate. As a result, their awareness of cardiovascular risk fac- tors, their approach to risk control, and their actu- al degree of risk factor management — including hypertension — may differ from those observed in the general population and among all individuals with hypertension. One example of such a differ- ence is the relatively low proportion of participants reporting alcohol consumption. In the present study, 67.5% of respondents reported abstaining from alcohol, 22.5% reported drinking 1–3 times per month, and only 9.9% reported consuming al- cohol once per week or more often. By comparison, in the 2019 MMM edition, 37.2% of participants reported abstinence, 59.1% consumed alcohol 1–3 times per month, and 3.5% reported drinking once per week or more often [9].

  generallimitationsevidence 5/5
  Keywords: hypertension reported participants individuals hypertensive measurements single diagnosis values included population risk alcohol current elevated
• VIVID ANALYSIS OF HYPERTENSION IN AYURVEDA (2026) · Zenodo (CERN European Organization for Nuclear Research) · doi

  National Institute for Health and Care Excellence statement 1: Diagnosis – (NICE). Quality ambulatory blood pressure monitoring [Internet]. London: NICE; 2015 [cited 2026 May 20]. Available from: https://www.nice.org.uk/guidance/qs28/chapter/qual ity-statement-1-diagnosis-ambulatory-bloodpressure-monitoring 19. Mayor S. Hypertension diagnosis should be based on ambulatory blood pressure monitoring, NICE recommends. BMJ., 2011; 343: d5421. 20. National Guideline Centre (UK). Hypertension in adults: diagnosis and management. NICE Guideline No.136. London: National Institute for Health and Care Excellence, 2019. 21. National Guideline Centre (UK). Evidence review for diagnosis: Hypertension in adults: diagnosis and management. London: National Institute for Health and Care Excellence, 2019. 22. National Guideline Centre (UK). Evidence review for monitoring: Hypertension in adults: diagnosis and management. London: National Institute for Health and Care Excellence, 2019. 23. Alagappan R. Manual of Practical Medicine. 5th ed. New Delhi: Jaypee Brothers Medical Publishers; 2014. 300 24. Penman ID, Ralston SH, Strachan MWJ, Hobson RP, editors. Davidson's Principles and Practice of Medicine. 24th ed. London: Elsevier, 2023; 448. 25. Mehta PJ. P. J. Mehta's Practical Medicine. 21st ed. Mumbai: The National Book Depot; Edited by Nihar P. Mehta NP, Mehta SP, Shashank R. Joshi SR., 2021; 52. 26. Raghuram YS. Hypertension: Types, Ayurvedic treatment, health tips [Internet]. Easy Ayurveda; 2015 Oct 21 [cited 2026 Mar 25].

  generalrecommendationsevidence 5/5
  Keywords: national diagnosis hypertension health nice london institute care excellence monitoring guideline mehta ambulatory blood pressure

Questions about this gap