With nearly half of American adults having elevated blood pressure (BP), it’s important for everyone to understand that some common habits may affect BP, making the condition more difficult to control.

That’s why the American Heart Association is providing quick reference tools for health-care providers to guide their patients in discovering “BP raisers” that are often hiding in plain sight:

Improper measurement: Mistakes taking BP can lead to false high readings. Ideally, patients will follow up in-office measurements with regular checks at home to rule out “white coat hypertension,” which occurs due to anxiety in a clinic setting. In either place, patients should be asked to prepare for a BP reading by emptying their bladder, avoiding cigarettes or caffeine for half an hour before the measurement, and sitting quietly for a few minutes before taking a reading. During the test, a patient should rest the arm being measured on a surface that’s chest level, feet should be flat on the floor, and no talking.

Over-the-counter medications: Common pain medicines called non-seroidal anti-inflammatory drugs (NSAIDs), such as naproxen and ibuprofen, can increase BP. Ask patients what they use to treat minor aches and pains. Drugs such as acetaminophen are less likely to increase BP. Decongestants are also known BP raisers. People with heart concerns should limit or avoid them, particularly if their BP is uncontrolled.

Health-care providers should screen for some prescription medicines that can affect BP: medicines to treat mental health, corticosteroids, oral birth control, immunosuppressants, and some cancer medications.

Alcohol and caffeine: Excesses of either can raise BP. Ask about these habits during office visits. Limited use is encouraged. Caffeine should be capped at three cups per day in general and avoided in most people with high BP.

Herbs and food combinations: Make sure patients understand that “natural” supplements and home remedies aren’t necessarily safe. Some herbal supplements, such as licorice, can raise BP. Other foods can interact with medications to have a negative effect. Strong cheeses, cured meats, soy products, and other foods that contain tyramine should be avoided by anyone taking antidepressants, such as monoamine-oxidase inhibitors (MAOIs).

A downloadable toolkit and other guides at www.heart.org/BPtools can help health-care providers and patients achieve successful BP management. The American Heart Association’s efforts to improve healthy choices related to living with high BP are proudly supported by Tylenol.