National Institute for Health and Care Excellence (NICE) guidance promotes the role of home blood pressure monitoring (HBPM) in the diagnosis and ongoing monitoring of patients with primary and secondary cardiovascular disease risk. Literature on this mostly originates from outside the UK though, with room for the development of UK nurse-led models of care, including self-management. The use of appropriately validated devices is fundamentally crucial, as is thorough patient education and establishing support for individuals. This article traces the development of HBPM and presents the concept of blood pressure variability, illustrating the context of the NICE guidance. Factors to consider when integrating HBPM into everyday practice are highlighted. Nurses caring for cardiac patients, especially in primary care, should assess the particular needs of their patient groups in approaching the use of HBPM.