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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 blood pressure both at home and in the office. The finding is an association, not proof that masked hypertension causes falls, and the study does not explain the possible link.
Adults older than 78 whose blood pressure was high at home but not in the medical office 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 in Arlington, Virginia. The finding suggests home readings may identify blood pressure patterns that an office measurement alone misses, but it does not show that masked high blood pressure causes falls.
The study included 758 adults older than 78. Researchers grouped participants by office and home blood pressure readings: 34.5% had high readings in both settings, a pattern described as sustained high blood pressure; 17% had high readings in the office but not at home, known as white coat high blood pressure; 15.4% had high readings at home but not in the office, or masked high blood pressure; 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 also says that, when differences between home and office readings were analyzed continuously, lower office readings relative to home readings were associated with a higher incidence of falls. The fall history was self-reported, and the available report does not specify that every fall occurred during the follow-up period.
Study presenter Frances Wang, a researcher at Beth Israel Deaconess Medical Center in Boston, said home monitoring can add information to clinical assessment and may help identify people with a hidden fall risk. The research was preliminary and presented at a scientific meeting; the source report does not describe it as proof of a cause-and-effect relationship.
Why Home Readings May Matter
The finding matters because blood pressure can differ between a clinic visit and a person’s usual environment. If clinicians rely only on an office measurement, they may not detect the high-at-home, normal-in-office pattern identified in this study. Home measurements could give health care teams additional information when reviewing an older patient’s blood pressure and fall history.
Falls are a serious concern 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 fall can threaten mobility and independence, but this study did not test whether treating masked high blood pressure prevents falls. The result points to an association that needs further investigation, not a demonstrated prevention strategy.
The finding also complicates the assumption that low blood pressure is the main blood-pressure-related concern when considering falls. The report notes emerging evidence linking high home blood pressure with falls in older adults. Researchers and clinicians will need more evidence to establish whether the pattern reflects blood pressure variability, another underlying factor, or a relationship that changes with further study.
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Office and Home Blood Pressure Patterns
Masked high blood pressure describes readings that are high outside a medical setting despite normal readings in the office. The contrasting white coat pattern involves high office readings but lower home readings. Comparing measurements from both settings can reveal differences that a clinic reading by itself does not show.
The American Heart Association’s 2025 joint guideline recommends annual blood pressure monitoring for all adults. It 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. The guideline context supports the use of home readings in care, but it is separate from the study’s preliminary finding about falls.
Wang said home measurements may help patients and caregivers share useful information with health care teams. Karol E. Watson, a volunteer expert for the American Heart Association who was not involved in the study, said normal office readings are not always the whole picture. Her comments interpret the findings; they are not results from the study itself.
“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, study presenter and researcher at Beth Israel Deaconess Medical Center
The Cause of the Fall Link
The study found an association, but it does not establish that masked high blood pressure led to falls. Why the risk was higher remains unknown, and the researchers did not identify a mechanism. Watson suggested blood pressure variability or regulation might be relevant, while stressing that the study did not explain the finding.
The report gives a median follow-up of 350 days and says falls were self-reported, including reports of at least one fall during the previous 12 months. It does not clarify the timing of each reported fall in relation to the blood pressure measurements, provide further detail about possible explanations for the association, or report whether the results have been published in a peer-reviewed journal. The findings are preliminary, so their size and meaning require confirmation in further research.
Further Study and Clinical Follow-Up
The findings were presented at the American Heart Association’s Hypertension Scientific Sessions, held October 7–11, 2026. The source report does not announce a next study, publication date, or additional results. Further research would be needed to test whether the association holds in other groups of older adults and to clarify how blood pressure patterns relate to falls.
For now, the American Heart Association guideline recommends home monitoring as part of an integrated care plan, including to help confirm an office diagnosis and track blood pressure. Wang encouraged older adults and caregivers to share home readings with the person’s health care team. The study does not establish that home monitoring or any particular blood pressure treatment will prevent falls; medical decisions should be discussed with a qualified health professional.
Key Questions
What does masked high blood pressure mean?
It means blood pressure readings are high at home but normal in the medical office. In this study, researchers compared readings from both settings to identify that pattern.
How much higher was the fall rate?
Among adults older than 78, the group with masked high blood pressure had a 70% higher rate of falls than the group with high blood pressure in both the office and at home. This is a comparison between the study groups, not proof that the blood pressure pattern caused falls.
How many people were in the study?
The analysis included 758 adults older than 78. During a median follow-up of 350 days, 23.4% reported at least one fall during the previous 12 months.
Does the study show that treating masked high blood pressure prevents falls?
No. The preliminary study reported an association and did not test whether treatment or home monitoring prevents falls. Its findings do not establish the cause of the higher rate.
What should older adults do with home blood pressure readings?
The American Heart Association recommends home monitoring as part of an integrated care plan and advises sharing readings with a health care team. People should discuss blood pressure concerns and treatment decisions with a qualified health professional.
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