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Preliminary research presented at the American Heart Association’s 2026 Hypertension Scientific Sessions found that adults older than 78 with masked high blood pressure had a 70% higher rate of falls than peers with high readings both at home and in the clinic. The study does not establish that masked hypertension causes falls, and researchers say the reason for the association is unknown.
Adults older than 78 whose blood pressure was high at home but not in the clinic had a 70% higher rate of falls than peers with high readings in both settings, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2026. The finding highlights how home measurements may reveal blood pressure patterns missed in medical offices, but the study does not show that masked high blood pressure causes falls.
The study included 758 adults older than 78. Researchers classified 15.4% as having masked high blood pressure, meaning their readings were high at home but not in the office. Another 34.5% had sustained high blood pressure, with elevated readings in both settings; 17.0% had white coat high blood pressure, with higher readings in the office; and 33.2% had normal readings in both settings.
Over a median follow-up of 350 days, 23.4% of participants reported having fallen at least once in the previous 12 months. The report says the comparison showing a 70% higher rate was between people with masked hypertension and those with sustained high blood pressure. It also reports that, when office and home readings were analyzed as continuous measures, lower office readings relative to home readings were associated with a higher incidence of falls.
The research was described as preliminary and presented at the American Heart Association meeting in Arlington, Virginia, held October 7–11. The report does not provide evidence that changing blood pressure treatment would prevent falls, nor does it establish the mechanism behind the observed association.
Why Home Readings May Matter
Blood pressure measured in a clinic may not reflect readings at home. The study’s results suggest that checking both settings could give clinicians more information when evaluating older adults, particularly when a person’s office readings appear normal. That distinction may matter in care decisions: relying on office measurements alone could leave some people’s elevated home readings unrecognized.
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 people aged 65 and older. The American Heart Association’s volunteer expert Karol E. Watson said falls can contribute to declines in physical and mental function when independence is lost. The study does not show that masked hypertension is responsible for those outcomes, but it offers a reason for further research into blood pressure patterns and fall risk.
The practical implication is not that people should change medication or treatment based on this study. Rather, the researchers say home readings can contribute useful information for discussion with a health care team. A clinician can interpret measurements alongside a person’s health history, medications and other fall-risk factors.
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Office and Home Readings Differ
Masked high blood pressure refers to a pattern in which readings are not high in a medical office but are elevated outside it, such as at home. The contrasting pattern, white coat high blood pressure, describes higher office readings than those recorded at home. Measuring blood pressure in both settings can therefore identify differences that a clinic reading alone may not show.
The American Heart Association’s 2025 joint guideline recommends annual blood pressure monitoring for all adults. It also recommends home monitoring to help confirm an office diagnosis of high blood pressure and to track readings and progress as part of an integrated care plan. Those recommendations provide context for the new findings; they do not mean the guideline established that home monitoring prevents falls.
Although low blood pressure is commonly considered a possible fall risk, the report notes that emerging evidence has also associated high home blood pressure with more falls among older adults. The new analysis adds a comparison among adults over 78, but further work is needed to clarify what the association means.
“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 Explain
The study reports an association, not proof that masked high blood pressure causes falls. It does not explain why the participants with masked readings had a higher fall rate, and Watson said blood pressure variability or the body’s ability to regulate readings during the day could be relevant possibilities. Those explanations remain unconfirmed.
The report does not give details about the number of falls in each blood pressure group, the severity of falls, or whether the analysis accounted for every factor that might affect fall risk. It also does not establish whether treating masked high blood pressure changes fall outcomes. The findings are preliminary, so they should not be treated as a basis for adjusting medication or care without clinical advice.
Further Study and Clinical Review
The findings were presented at the American Heart Association’s 2026 Hypertension Scientific Sessions, and the report does not announce a specific next study or follow-up date. Further research would be needed to test whether the association holds in other groups of older adults, identify possible explanations and determine whether any clinical response can reduce falls.
For now, Wang encouraged older adults, family members and caregivers to consider taking regular home blood pressure measurements and sharing the results with a health care team. The association does not mean every older person with a high home reading is at elevated fall risk. Clinicians can assess readings in context and discuss appropriate monitoring and care.
Key Questions
What does masked high blood pressure mean?
It means blood pressure is high at home but not high in a medical office. The pattern can be missed if assessment relies only on clinic readings.
How much higher was the fall rate?
Among adults older than 78, those with masked high blood pressure had a 70% higher rate of falls than participants whose readings were high both at home and in the office. The report does not establish that the blood pressure pattern caused the difference.
Does the study prove high blood pressure causes falls?
No. The research found an association, and the reason for it remains unknown. The study does not show that treating masked high blood pressure will prevent falls.
Should older adults monitor blood pressure at home?
The American Heart Association recommends home monitoring as part of an integrated care plan to help confirm a diagnosis and track readings. The study’s presenting author also advised sharing home measurements with a health care team. People should ask a clinician how to measure and interpret their readings and should not change treatment based on the study alone.
Source: rss
