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

TL;DR

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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 whose blood pressure was high both at home and in medical offices. The findings suggest home readings may add useful information, but the study does not establish that masked hypertension causes falls or explain the association.

A preliminary study of 758 adults older than 78 found that people with masked high blood pressure—normal readings in 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 were presented at the American Heart Association’s Hypertension Scientific Sessions in Arlington, Virginia, and point to home measurements as a possible way to identify risks that an office reading may not reveal.

Researchers classified participants according to blood pressure readings taken in medical and home settings. 15.4% had masked high blood pressure, while 34.5% had sustained high blood pressure, meaning readings were high in both settings. Another 17.0% had white coat high blood pressure—high readings in the office but not at home—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 during the previous 12 months. The report also said that, when office and home readings were analyzed as continuous measures, lower office blood pressure relative to home blood pressure was associated with a higher incidence of falls. The 70% comparison was specifically between people with masked hypertension and those with sustained hypertension; it should not be read as a comparison with everyone who had normal readings.

The research is preliminary and was presented at a scientific meeting. The source report does not provide enough detail to determine whether the findings have undergone peer-reviewed journal publication. The study reports an association, not evidence that masked high blood pressure directly caused participants to fall.

Why Home Readings May Matter

The results matter because an office measurement alone may not reflect a person’s blood pressure at home. If a person’s readings are repeatedly high outside the clinic, that information could affect how clinicians assess blood pressure and plan follow-up. Study presenting author Frances Wang, a researcher at Beth Israel Deaconess Medical Center, said home monitoring can help identify “hidden high blood pressure at home” and may provide information relevant to fall risk.

Falls can have serious consequences 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. The findings do not show that treating masked hypertension will prevent falls, but they support further attention to blood pressure patterns alongside routine fall-risk assessment.

The American Heart Association recommends annual blood pressure monitoring for adults and recommends home monitoring to help confirm an office diagnosis and track readings as part of an integrated care plan. The study adds a possible reason for clinicians and patients to discuss readings taken outside the clinic, while leaving the clinical meaning of the fall association to be investigated.

Office and Home Readings Differ

Masked hypertension describes a pattern in which blood pressure is not high in the office but is high at home. It differs from sustained high blood pressure, where readings are elevated in both settings, and from white coat high blood pressure, where the office reading is high but the home reading is not. These categories were used to compare fall reports in this study of people older than 78.

Low blood pressure is often considered when clinicians assess falls, but the Medical Xpress report notes emerging evidence linking high blood pressure at home with falls in older adults. The study’s results align with the American Heart Association’s 2025 guideline, which recommends annual monitoring and says home readings can help confirm a diagnosis, track progress and inform care. The guideline is broader than this study and does not establish that home monitoring prevents 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 Show

The study does not establish why people with masked high blood pressure reported more falls, or whether their blood pressure pattern contributed to the falls. Watson said the results may relate to blood pressure variability or how well older adults regulate blood pressure during the day, but described this as a possibility, not a demonstrated explanation.

The source report does not give details about the study design, recruitment, fall verification, or adjustments for other factors that can influence fall risk. It also does not clarify whether the reported falls occurred during the follow-up period: the measure is described as self-reported falls in the previous 12 months, alongside a median follow-up of 350 days. The findings are preliminary, and it is not clear from the report whether the association will hold in other groups or after further study.

Further Research and Clinical Follow-Up

Further research will be needed to test whether the association persists in larger or different groups of older adults and to identify possible reasons behind it. The report does not announce a follow-up study or give a timeline for additional results.

For now, the American Heart Association’s guidance supports annual blood pressure monitoring and home readings as part of care for patients. Wang encouraged older adults, family members and caregivers to share home measurements with a health care team. The findings are not a treatment recommendation and do not show that changing blood pressure will prevent falls; clinical decisions should be made with a qualified health professional.

Key Questions

What is masked high blood pressure?

It is a pattern in which blood pressure is normal in a medical office but high at home. The study compared this group with people whose readings were high in both settings, among other categories.

How much higher was the fall rate?

Adults with masked high blood pressure had a 70% higher rate of falls than those with high readings both at home and in the office. This was the study’s specific comparison, not a comparison with all participants.

Does the study prove masked hypertension causes falls?

No. The preliminary study found an association; it did not show that masked high blood pressure caused falls or establish why the groups differed.

How many people took part?

The study included 758 adults older than 78. Researchers reported that 23.4% said they had fallen at least once in the previous 12 months.

What should older adults do with home blood pressure readings?

The American Heart Association recommends home monitoring in appropriate care plans and sharing readings with a health care team. This study does not provide personal medical advice or show that home monitoring itself prevents falls; patients can ask a qualified health professional how to measure and interpret their readings.

Source: rss