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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 participants with high readings in both settings. The results were presented at the American Heart Association’s Hypertension Scientific Sessions 2026; they show an association, not that masked hypertension causes falls.
Adults older than 78 whose blood pressure was normal in a medical office but high at home 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 2026. The finding suggests that office measurements alone may miss information relevant to fall risk, but the study does not establish that masked high blood pressure causes falls.
The study included 758 adults older than 78, grouped according to office and home blood pressure readings. Researchers classified 15.4% of participants as having masked high blood pressure, meaning their office readings were not high while their home readings were. Another 34.5% had sustained high blood pressure, with elevated readings in both settings; 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, 23.4% of participants reported having fallen at least once during the previous 12 months. The research summary says the comparison between masked and sustained high blood pressure showed a higher fall rate in the masked group. It also reports that, when office and home readings were analyzed as a continuous difference, lower office readings relative to home readings were associated with more falls.
Presenting author Frances Wang, a researcher at Beth Israel Deaconess Medical Center in Boston, said home monitoring can help identify high blood pressure that may not appear during an office visit. The results were presented as preliminary research at the meeting in Arlington, Virginia, held October 7–11, 2026.
Why Home Readings May Matter
Blood pressure is often assessed during clinic visits, but readings can differ between the office and a person’s usual environment. The study’s findings point to a potential gap: an office result that appears normal may not reflect higher blood pressure at home. For older adults, that difference could be relevant when clinicians assess overall health and fall risk.
Falls can lead to injury, reduced mobility and loss of independence. The U.S. Centers for Disease Control and Prevention identifies falls as the leading cause of disability and functional decline in adults aged 65 and older. The study does not show that treating masked high blood pressure would prevent falls, nor does it establish why the association appeared. It does support further attention to home readings as part of clinical assessment, rather than treating a single office measurement as a complete picture.
Wang said the findings may help clinicians identify patients who have hidden fall risk. American Heart Association volunteer expert Karol E. Watson, who was not involved in the research, said the results warrant closer examination and raised the possibility that blood pressure variability or difficulty regulating blood pressure could be relevant. Those are possible explanations, not conclusions established by this study.
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How the Study Classified Blood Pressure
Masked high blood pressure describes a pattern in which office readings are not elevated while readings taken outside the clinic, such as at home, are high. The contrasting “white coat” pattern refers to higher readings in the medical setting than at home. Sustained high blood pressure means readings are elevated in both settings. These categories describe measurement patterns; they do not, on their own, explain an individual’s fall risk.
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 blood pressure and treatment as part of an integrated care plan. The new research aligns with that emphasis on measurements beyond the clinic, while adding a preliminary finding about falls among people older than 78.
The report notes that low blood pressure is commonly regarded as a fall risk factor, while previous research has also suggested a connection between high blood pressure measured at home and falls in older adults. The current study adds a comparison among blood pressure patterns, but its results are not yet a clinical trial or proof of a cause-and-effect relationship.
“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 presenting author and Beth Israel Deaconess Medical Center researcher
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Cause and Mechanism Remain Unknown
The findings are preliminary and were presented at a scientific meeting. The report does not establish that masked high blood pressure directly causes falls, or that lowering home blood pressure would reduce them. Watson said the study does not explain why the masked group had a higher fall rate; blood pressure variability and regulation were offered as possibilities, not demonstrated mechanisms.
The summary also says participants self-reported falls during the previous 12 months and describes a median follow-up of 350 days. It does not provide further detail on the timing of each fall relative to blood pressure measurements, the number of falls in each blood pressure group, or how other factors that affect falls were accounted for. The reported 70% comparison is specifically against participants with high readings in both the office and at home; it should not be read as a comparison with every other group.
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Further Research and Clinical Follow-Up
The study was presented during the American Heart Association’s October 2026 hypertension sessions. The available report does not identify a journal publication or announce a planned follow-up study. Further research would need to test whether the association holds in other groups and clarify the role of blood pressure patterns and other fall-risk factors.
Wang encouraged older adults, family members and caregivers to measure blood pressure regularly at home and share the readings with a health care team. The American Heart Association recommends using home monitoring alongside clinical care, not as a substitute for it. People should discuss readings and any treatment decisions with their health professional, particularly when they have existing conditions or are taking blood pressure medication.
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Key Questions
What is masked high blood pressure?
It is a pattern in which blood pressure readings are not high at a medical office but are high when measured at home or outside the clinic.
How much higher was the fall rate?
In this study, adults older than 78 with masked high blood pressure had a 70% higher fall rate than those whose readings were high both at the office and at home. That comparison does not mean the risk was 70% higher than for every participant or that blood pressure caused the falls.
Does the study prove masked high blood pressure causes falls?
No. The research found an association, and the report says the study did not explain why the fall rate was higher. It also does not show that treating masked high blood pressure would prevent falls.
Why take blood pressure at home?
Home readings can reveal a different pattern from office measurements and may help a clinician assess blood pressure over time. The American Heart Association recommends home monitoring as part of an integrated care plan; patients should discuss their readings with a health care professional.
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