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A preliminary study of 758 adults older than 78 found those with masked high blood pressure had a 70% higher rate of falls than peers whose blood pressure was high in both medical offices and at home. The findings, presented at an American Heart Association meeting, show an association and do not establish that masked hypertension causes falls.
Adults older than 78 with masked high blood pressure had a 70% higher rate of falls than peers whose blood pressure was high both at medical appointments and at home, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2026. The study points to a possible role for home blood pressure readings in identifying older adults who may have elevated fall risk, but it does not show that hidden high blood pressure causes falls.
The researchers studied 758 adults older than 78, classifying their blood pressure using readings taken in medical settings and at home with tools such as wrist blood pressure monitors. They described masked high blood pressure as readings that were normal in the office but high at home. In contrast, people with sustained high blood pressure had elevated readings in both settings.
The group included 15.4% with masked high blood pressure, 34.5% with sustained high blood pressure, 17.0% with white coat high blood pressure, and 33.2% with normal readings. White coat high blood pressure refers to elevated readings in a medical setting that are not elevated at home. Over a median follow-up of 350 days, 23.4% of participants reported at least one fall in the previous 12 months.
The analysis also found that, when office and home blood pressure differences were considered as a continuous measure, lower office readings relative to home readings were associated with a higher incidence of falls. The study report does not establish a cause for this pattern. Its fall information was self-reported, and the findings are preliminary research presented at a scientific meeting.
Why Home Readings May Matter
Blood pressure measured during a clinic visit may not show what a person’s readings are like at home. The study suggests that this difference could be relevant when clinicians assess older patients who may be at risk of falls. Home monitoring may add information to office measurements, although these results do not show that monitoring itself prevents falls or that treating masked hypertension would reduce them.
Falls can have serious consequences for older adults. The U.S. Centers for Disease Control and Prevention identifies falls as the leading cause of disability and functional decline among adults 65 and older. A better understanding of factors associated with falls could help clinicians decide what to assess, but the study’s findings need further investigation before they can guide specific fall-prevention decisions.
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How the Blood Pressure Groups Differed
Masked high blood pressure describes a mismatch: readings appear normal in the office but are high at home. That pattern can be missed if assessment relies only on clinic measurements. The study compared the group with masked high blood pressure against people with sustained high blood pressure, whose readings were elevated in both settings.
The American Heart Association’s 2025 blood pressure guideline recommends annual blood pressure monitoring for adults. It also recommends home monitoring to help confirm an office diagnosis and to track readings and progress as part of an integrated care plan. The guideline recommendation provides context for the study; it does not mean this research has shown that home monitoring prevents falls.
“These findings highlight that, in addition to office blood pressure measurement, home blood pressure readings can be an important way to identify hidden high blood pressure at home and risk of falls in older adults.”
— Frances Wang, Ph.D., M.S., study presenting author and researcher at Beth Israel Deaconess Medical Center
What the Study Cannot Establish
The findings show an association, not cause and effect. Researchers have not established why participants with masked high blood pressure reported more falls, whether blood pressure variability played a role, or whether other factors account for the relationship. Watson said the study does not explain the reason for the higher rate.
The report describes preliminary findings from a scientific meeting, rather than a result that by itself settles clinical practice. Falls were self-reported, and the reported follow-up was a median of 350 days; the account also says participants reported falls during the previous 12 months. More details would be needed to judge how the study’s methods and timing affect interpretation. The available material does not state whether the findings have been published in a peer-reviewed journal.
Further Research and Home Monitoring
The findings were presented at the American Heart Association’s Hypertension Scientific Sessions, held in Arlington, Virginia, from October 7 to 11, 2026. The study report does not identify a next research milestone or say whether follow-up studies are planned. Further research would need to test whether the association holds in other groups and clarify what might account for it.
Wang said older adults, family members, and caregivers could measure blood pressure regularly at home and share the readings with a health care team. The American Heart Association guideline also supports home monitoring as part of blood pressure assessment and care. Decisions about interpreting readings or changing treatment should be discussed with a qualified health professional; the study is not evidence that a particular intervention prevents falls.
Key Questions
What does masked high blood pressure mean?
It means blood pressure is normal in a medical office but high at home, based on the readings used in this study.
How much higher was the fall rate?
The study reported a 70% higher rate of falls for participants with masked high blood pressure than for those with high readings both in the office and at home. This is a comparison between study groups, not proof that masked high blood pressure caused falls.
How many people took part?
The analysis included 758 adults older than 78. The findings were preliminary research presented at a scientific meeting.
Does the study show that home monitoring prevents falls?
No. It suggests home readings may help identify blood pressure patterns associated with falls, but it did not test whether monitoring or a specific treatment prevents falls.
What should older adults do with home readings?
Wang recommended sharing home readings with a health care team. People should consult a qualified health professional about how to interpret readings and make care decisions.
Source: rss
