Elderly Adults With Masked High Blood Pressure Linked To Higher Risk Of Falls

TL;DR

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A preliminary study of 758 adults older than 78 found that those with masked high blood pressure had a 70% higher rate of falls than participants whose blood pressure was high both at home and in the office. The findings were presented at the American Heart Association’s 2026 Hypertension Scientific Sessions; they show an association, not that masked high blood pressure 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 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 reveal a pattern that an office measurement alone can miss, but the study shows an association and does not establish that masked high blood pressure causes falls.

The study included 758 adults older than 78, grouped according to blood pressure readings taken in a medical office and at home. Researchers classified 15.4% as having masked high blood pressure: their office readings were not high, while their home readings were. Another 34.5% had high readings in both settings, a pattern described as sustained high blood pressure; 17% had high office readings but not high home readings, known as white coat high blood pressure. The remaining 33.2% had normal readings in both settings.

Over a median follow-up of 350 days, 23.4% of participants reported at least one fall during the previous 12 months. The report says falls were self-reported, and the fall question covered a 12-month period, while follow-up had a median length of nearly a year. Researchers also found that, when office and home readings were examined as continuous measurements, lower office blood pressure relative to home blood pressure was associated with a higher incidence of falls.

Frances Wang, the study’s presenting author and a researcher at Beth Israel Deaconess Medical Center in Boston, said home monitoring can add information to clinical assessments and may help identify people with hidden risk. The research was presented at a scientific meeting and is described as preliminary; the report does not provide details of a peer-reviewed publication or establish a cause-and-effect relationship.

Why Home Readings May Matter

Blood pressure measured in a clinic may not reflect a person’s readings in everyday settings. The study’s finding that the masked-high-blood-pressure group had a higher fall rate than the sustained-high group highlights a possible limitation of relying on office readings alone when evaluating older adults. It does not show that home monitoring prevents falls, but it supports considering readings from both settings as part of a broader clinical assessment.

The stakes are substantial for older people: the report cites the U.S. Centers for Disease Control and Prevention as saying falls are the leading cause of disability and functional decline among adults 65 and older. A fall can threaten mobility and independence. However, the study did not establish why the observed association occurred, and its results should not be taken to mean that high blood pressure is a proven cause of falls in this group.

For patients and caregivers, the practical point is to discuss home blood pressure readings with a health professional rather than treating one set of readings as a diagnosis or changing care without guidance. The American Heart Association recommends home monitoring to help confirm an office diagnosis, follow blood pressure over time and inform care planning.

Office and Home Readings Differ

Masked high blood pressure refers here to readings that are not high in the office but are high at home. The reverse pattern—high in the office and not high at home—is called white coat high blood pressure. Readings elevated in both settings were classified as sustained high blood pressure. These categories make clear why a single office measurement may not describe every person’s blood pressure pattern.

The research was presented at the American Heart Association’s Hypertension Scientific Sessions 2026, held October 7–11 in Arlington, Virginia. The association’s 2025 joint guideline recommends annual blood pressure monitoring for all adults and recommends home monitoring to help confirm office diagnoses and track readings as part of an integrated care plan. That guidance provides relevant context, but it is not evidence that home monitoring by itself reduces 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 Beth Israel Deaconess Medical Center researcher

Cause and Mechanism Remain Unknown

The findings do not explain why the masked-high-blood-pressure group reported more falls. Watson said the pattern may relate to blood pressure variability or regulation, but the study did not establish either explanation. The results also do not show that treating masked high blood pressure would reduce falls.

The report describes the research as preliminary and says participants self-reported falls. It does not give the number of falls in each blood pressure group, the study’s full methods, or enough detail to determine how other differences between participants may have affected the results. The reported 70% comparison is between the masked-high group and the group with high readings in both settings; it should not be generalized to every older adult or treated as an individual prediction.

Clinical Follow-Up and Further Study

The next steps are not specified in the report. The findings were presented at a scientific meeting, and further research would be needed to test whether the association holds in other groups, clarify why it occurs and determine whether acting on home readings changes fall outcomes. Details of any planned follow-up or publication were not provided.

Wang encouraged older adults, family members and caregivers to measure blood pressure regularly at home and share the results with a health care team. The American Heart Association recommends using home monitoring as part of care planning. Anyone concerned about blood pressure or falls should discuss readings and fall risk with a qualified health professional; this preliminary study is not a basis for changing treatment on its own.

Key Questions

What does masked high blood pressure mean in this study?

It means a participant’s blood pressure was not high in the office but was high at home, according to the study’s categories.

How much higher was the fall rate?

The masked-high-blood-pressure group had a 70% higher rate of falls than participants whose readings were high both in the office and at home. This is a comparison between those study groups, not a prediction for an individual.

Does the study prove that masked high blood pressure causes falls?

No. The research found an association and did not establish a cause, explain the mechanism or show that treating the condition would prevent falls.

What should older adults do with home blood pressure readings?

The American Heart Association recommends home monitoring to help confirm an office diagnosis and track readings as part of care. People should share readings with a health care professional rather than make treatment changes based only on this preliminary study.

Source: rss