TL;DR
A preliminary study of 758 adults older than 78 found that those with masked high blood pressure—normal readings at a medical office but high readings at home—had a 70% higher rate of falls than those with high readings in both settings. The findings were presented at the American Heart Association’s Hypertension Scientific Sessions 2026; they show an association, not that masked hypertension causes falls.
A preliminary study of 758 adults older than 78 found that people with masked high blood pressure—normal readings at a medical office but high readings at home—had a 70% higher rate of falls than peers whose blood pressure was high in both settings. The findings, presented at the American Heart Association’s Hypertension Scientific Sessions in Arlington, Virginia, point to home measurements as a possible way to identify blood pressure patterns that an office reading alone may miss.
The researchers classified participants according to their blood pressure readings at a medical office and at home. Masked high blood pressure means the office reading is not high while the home reading is; sustained high blood pressure means readings are high in both settings. In the study, 15.4% had masked hypertension, while 34.5% had sustained high blood pressure, 17.0% had white-coat high blood pressure and 33.2% had normal readings in both settings.
During a median follow-up of 350 days, nearly one in four participants—23.4%—reported that they had fallen at least once in the previous 12 months. Researchers also found that, when office and home readings were assessed as a continuous difference, lower office pressure relative to home pressure was associated with a higher incidence of falls. The report does not provide enough detail to treat the 70% difference as proof that masked hypertension caused those falls.
The study’s presenting author, Frances Wang, a researcher at Beth Israel Deaconess Medical Center in Boston, said home readings can add information to clinical assessment and may help identify people with hidden fall risk. Wang encouraged older adults, family members and caregivers to take regular home measurements and share them with a health care team. The report describes the research as preliminary and says it was presented at the scientific sessions.
Why Home Readings May Matter
The findings matter because a blood pressure check taken in a clinic may not reflect readings at home. If the association is borne out in further research, home monitoring could help clinicians identify older patients whose blood pressure pattern is not apparent during an office visit. That could inform a broader care discussion, including how to monitor blood pressure and assess fall risk.
Falls can have serious consequences for older people. 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. Still, this study does not establish that high home blood pressure directly leads to falls, or that changing blood pressure treatment would prevent them. The result is a signal for further investigation, not a treatment recommendation on its own.
How the Blood Pressure Groups Differed
The study compared blood pressure measured in two settings: a medical office and the participant’s home. White-coat high blood pressure refers to high readings in the office but not at home; masked high blood pressure describes the reverse. Sustained high blood pressure is high in both settings. These categories help explain why a single measurement may not capture a person’s usual readings.
The American Heart Association’s 2025 joint 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 current findings align with that emphasis, but do not establish a new clinical guideline or show that home monitoring itself reduces falls.
“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 report describes an association, so it cannot show that masked high blood pressure caused participants to fall. The reported findings do not explain the mechanism behind the difference, whether blood pressure variability contributed, or whether another factor influenced both readings and falls. Watson, who was not involved in the study, said the research does not explain why the fall rate was higher.
The source reports that participants self-reported falls and gives a median follow-up of 350 days, but it does not provide further details here about the number of falls in each blood pressure group, the statistical uncertainty around the 70% comparison, or how other fall-risk factors were handled. It is also unclear whether the findings will be published in a peer-reviewed journal or confirmed in other groups. The result should not be read as evidence that an individual’s blood pressure treatment should be changed without clinical advice.
Further Study and Clinical Review
The findings were presented at the American Heart Association’s Hypertension Scientific Sessions 2026, held Oct. 7–11. The source report does not describe a planned follow-up study or give a date for publication of a full research paper. Further research would be needed to test whether the association appears in other populations and to clarify what might account for the higher fall rate.
For now, the researchers’ practical message is to share home blood pressure readings with a health care team. The American Heart Association guideline recommends home monitoring as part of an integrated care plan, including to confirm an office diagnosis and track readings over time. Decisions about monitoring or treatment should be discussed with a clinician, particularly for older adults with concerns about falls.
Key Questions
What is masked high blood pressure?
It is a pattern in which blood pressure is not high at a medical office but is high when measured at home.
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 at home and in the office. This is an association, not proof that masked hypertension caused falls.
How many people took part?
The analysis included 758 adults older than 78. Nearly one in four participants reported at least one fall in the previous 12 months.
Does the study show that treating masked hypertension prevents falls?
No. The report does not establish that blood pressure caused the falls or that changing treatment would prevent them. Treatment decisions should be made with a health care professional.
What did the researchers recommend?
Presenting author Frances Wang encouraged older adults, family members and caregivers to measure blood pressure at home regularly and share the readings with a health care team. The study did not test whether home monitoring reduces falls.
Source: rss
