Fillable Printable Blood Pressure Tracking Card
Fillable Printable Blood Pressure Tracking Card
Blood Pressure Tracking Card
CALL 311
OR VISIT NYC
.GOV/HEALTH
THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE
BLOOD PRESSURE
TRACKING C ARD
PERSONAL INFORMATIONMY ACTION PLAN
TAKE CARE NEW YORK
KEEP YOUR HEART HEALTHY
Check each box as you decide to make any of these lifestyle
changes.
I will quit smoking.
I will engage in physical activity most days of the week.
I will choose foods that are low in salt (sodium).
I will know my blood pressure numbers.
I will know my blood pressure medications.
I will take my blood pressure medications as directed.
I will eat a diet low in saturated and trans fat.
I will limit my alcohol intake.
I will monitor my blood pressure.
I will work to lessen day-to-day stress.
My own blood pressure goal:_______________________
For more information,
talk with your healthcare provider or call 311.
NAME:
HEALTHCARE PROVIDER:
BLOOD PRESSURE MEDICATIONS:
SPECIAL INSTRUCTIONS
(Ask your healthcare provider)
When my blood pressure
is above / I should
When my blood pressure
is below / I should
KEEP YOUR
HEART HEALTHY
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
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THINGS YOU CAN DO TO LOWER HIGH BLOOD PRESSURE,
PROTECT YOUR HEART AND PREVENT STROKE.
HPD1X25700 - 9.05
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
DATE AM/PM
BLOOD
PRESSURE
Use this chart to keep track of your blood pressure. Talk with your healthcare provider about how often to take your blood pressure. Write in the date and results in each box.
MY BLOOD PRESSURE GOAL IS
______ /______
I will check my blood pressure ever y
day
in the
AM
week PM
Special Instructions________________
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________________________________
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