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A preliminary study of 758 adults older than 78 found that masked high blood pressure—normal readings at a medical office but high readings at home—was associated with a 70% higher rate of falls than high blood pressure in both settings. The research, presented at the American Heart Association’s 2026 Hypertension Scientific Sessions, does not establish why the association occurred or that masked hypertension causes falls.
Adults older than 78 whose blood pressure was high at home but not in a medical office had a 70% higher rate of falls than peers whose readings were high in both settings, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions in Arlington, Virginia. The finding highlights the potential value of home readings in identifying blood pressure patterns that office checks alone may miss, but the study does not show that masked high blood pressure causes falls.
The analysis included 758 adults older than 78, classified according to blood pressure readings taken in medical and home settings. Researchers reported that 15.4% had masked high blood pressure, meaning readings were high at home but not in the office. Another 34.5% had sustained high blood pressure, with high 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.
During a median follow-up of 350 days, 23.4% of participants reported that they had fallen at least once in the preceding 12 months. The reported 70% difference compares the rate of falls among participants with masked high blood pressure with the rate among those with sustained high blood pressure. It is a relative comparison between those groups; the report does not give the absolute fall rates for each group.
The researchers also found that, when office and home blood pressure differences were assessed as a continuous measure, lower office readings relative to home readings were associated with a higher incidence of falls. The study was presented as preliminary research at the American Heart Association meeting and has not, in the supplied report, been described as a peer-reviewed publication.
The findings matter because a blood pressure check in a clinic may not reflect a person’s readings at home. If the association is borne out in further research, home measurements could provide clinicians with information to consider alongside office readings when evaluating older adults who may be at risk of falls. The study does not establish that measuring blood pressure at home prevents falls, or that changing treatment based on these readings would reduce them.
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. Study presenter Frances Wang said home readings may help identify hidden high blood pressure and inform care. Her comments describe a potential use of the findings, not a tested fall-prevention intervention.
For readers, the practical message is about sharing information with a care team, not drawing conclusions from a single reading. The American Heart Association recommends home monitoring in appropriate care plans to help confirm an office diagnosis, track blood pressure and guide clinical discussions. Decisions about interpreting readings or adjusting medication should be made with a qualified health professional.
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Why Office and Home Readings Differ
Masked high blood pressure refers to readings that are not high in a medical setting but are high outside it, such as at home. It contrasts with sustained high blood pressure, in which readings are elevated in both settings, and white coat high blood pressure, in which readings are elevated in the office but not at home. These categories depend on measurement across settings rather than a single clinic reading.
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 and to support monitoring and care planning. The current study’s findings align with that guidance, but the guideline recommendation is not evidence that home monitoring itself prevents falls.
The research also comes amid a broader question about blood pressure and falling. Low blood pressure is commonly considered a possible falls risk, while the report notes emerging evidence linking high home blood pressure with more falls in older adults. The new analysis adds an association in a particularly old study group; it does not resolve how blood pressure patterns may relate to 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 presenter and researcher at Beth Israel Deaconess Medical Center
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Cause and Absolute Risk Remain Unknown
The study found an association, but it did not determine why people with masked high blood pressure had a higher rate of falls. The report does not establish whether blood pressure variability, difficulty regulating blood pressure, other health factors or another explanation accounts for the pattern. Watson said those possibilities need a closer look; they remain explanations to investigate, not findings proven by this analysis.
The available report also does not provide the absolute fall rate for each blood pressure group, so readers cannot calculate how many additional falls occurred in the masked group from the 70% relative comparison alone. Falls were self-reported, and the report says participants reported at least one fall during the previous 12 months while the median follow-up was 350 days. Further detail would be needed to assess how the timing and measurement of falls affected the analysis.
It is also unclear from the report whether results apply to younger adults, people in different care settings or groups not represented in this sample. The findings are preliminary, and the supplied material does not report whether researchers tested a blood pressure or falls-prevention intervention.
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Further Research Must Test the Link
The study was presented at the American Heart Association’s Hypertension Scientific Sessions 2026, held Oct. 7–11 in Arlington. The supplied report does not announce a next study, a publication date or a planned clinical trial. Additional research would be needed to confirm the association, clarify the absolute fall rates and investigate what may explain the difference between home and office readings.
For now, the American Heart Association’s existing guidance supports home blood pressure monitoring as part of an integrated care plan. Older adults and caregivers can discuss how and when to measure blood pressure with a health professional and share readings with the care team. The study does not support changing medication or treatment on the basis of its findings alone.
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Key Questions
What does masked high blood pressure mean?
Masked high blood pressure means readings are high at home or outside a medical office but are not high in the office. In this study, researchers compared readings from both settings.
How much higher was the reported fall rate?
The study reported a 70% higher rate of falls for adults with masked high blood pressure compared with those whose readings were high both at home and in the office. The report does not provide the absolute fall rates for those two groups.
Does the study show that masked high blood pressure causes falls?
No. The research found an association and did not establish that masked high blood pressure caused the falls or explain why the groups differed.
Who took part in the study?
The analysis included 758 adults older than 78. The reported findings may not apply to younger people or other populations.
Should someone change medication because of these findings?
The report does not recommend changing medication based on this study. People should discuss home readings and treatment questions with a qualified health professional.
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