One of the main challenges in implementing an optimal home-based exercise program in older adults and individuals with cardiovascular conditions is the requirement to ensure exercise safety and prevention of any undesirable side effects. A crucial component to achieve this requirement is the ability to monitor blood pressure (BP) during exercise. The goal of this project was to introduce and to test a practical low-cost solution for using pulse transit time (PTT) to estimate BP during exercise. Our approach was based on obtaining 3 calibration points during different levels of exertion for each subject and utilizing the resulting individualized BP estimation equitation for patient-specific monitoring of BP during home-based exercise. Evaluation of the proposed approach showed that the mean difference between reference systolic BP (SBP) and estimated systolic BP was 1.1 mmHg. Telecare systems can be enhanced by utilizing PTT-based individualized estimation equations for monitoring BP changes during exercise.