This is the final version. Available on open access from Springer Nature via the DOI in this recordAnkle blood pressure (BP) measurement is necessary for the diagnosis of hypertension where measurements are not possible due to medical conditions or limb deformities. Based on a recent review of the evidence, we recommend an ankle BP threshold of ≥155/90 mmHg to define high blood pressure in patients who do not have vascular disease. We recommend that ankle BP readings are taken with the subject lying down, using a validated automated device with the cuff placed around the ankle/lower calf.Wellcome TrustRoyal SocietyNational Institute for Health Research (NIHR