Adding a note with your BP reading that describes the conditions at the time of the reading may offer your doctor insight as to why the BP was outside the patient's normal range. Was it an anomoly, or was it the start of a serious trend to keep closer watch. A patient's notes would help the doctor determine how much the patient's environment, especially relationships, are affecting their BP as a factor of daily stress. Notes could also help their doctor uncover a new or latent, underlying medical condition.