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In a preliminary study of 758 adults older than 78, those with high blood pressure at home but not in the clinic had a 70% higher rate of falls than those with high readings in both settings. The findings, presented at the American Heart Association’s 2026 Hypertension Scientific Sessions, show an association, not proof that masked high blood pressure causes falls.
A preliminary study of 758 adults older than 78 found that participants 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. The research was presented at the American Heart Association’s Hypertension Scientific Sessions 2026 in Arlington, Virginia; it identifies an association and does not establish that masked high blood pressure causes falls.
The researchers classified participants by blood pressure readings taken in clinical and home settings. Masked high blood pressure means readings are not high in the medical office but are elevated at home. In the study, 15.4% of participants had this pattern. Another 34.5% had sustained high blood pressure, with elevated 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 having fallen at least once in the previous 12 months. The comparison reported by the researchers was between the masked-high-blood-pressure group and participants with sustained high blood pressure. The article does not provide the fall rate for each group or a confidence interval for the reported 70% difference.
The analysis also found that, when the difference between office and home blood pressure was examined continuously, lower office readings relative to home readings were associated with a higher incidence of falls. The research was described as preliminary. The published account does not provide enough methodological detail to determine how other factors that may affect fall risk were handled.
The findings suggest that clinic readings alone may not capture the blood pressure pattern associated with falls in some very old adults. A person whose office measurement appears normal may have higher readings at home, a difference that could otherwise go unnoticed during routine care.
Falls are a major health concern for older people: the U.S. Centers for Disease Control and Prevention identifies them as the leading cause of disability and functional decline among adults aged 65 and older. The study’s presenting author, Frances Wang, said home measurements could add information for clinical assessment and help identify a possible hidden fall risk. That is a reason to discuss readings with a health care professional, not a basis for changing treatment without medical advice.
The study does not explain why the association appeared. It cannot show that treating home blood pressure differently would prevent falls, and it does not establish that masked high blood pressure is a cause of falling. Its results point to a relationship researchers say warrants further investigation.
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How Office and Home Readings Differ
Blood pressure can vary between a medical visit and a person’s home. The study separated participants into four groups based on those readings: sustained high blood pressure, white coat high blood pressure, masked high blood pressure, and normal readings in both settings. The central comparison was the masked pattern against sustained high blood pressure, not against every other group combined.
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 of high blood pressure and to track readings as part of an integrated care plan. The study authors said their findings support the value of including home measurements in assessment, but the guideline recommendation is not a finding that home monitoring itself prevents falls.
Wang, the presenting author and a researcher at Beth Israel Deaconess Medical Center in Boston, said prior studies have also associated high home blood pressure with falls in older adults. The supplied report does not describe those studies in detail, so their methods and results cannot be compared here.
““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
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Cause and Fall Rates Remain Unknown
The study found a statistical association but does not show why participants with masked high blood pressure had a higher fall rate. Watson suggested blood pressure variability or difficulty regulating blood pressure as possible explanations, while stressing that the study does not explain the result. Those possibilities remain interpretations, not established mechanisms.
The available report also leaves important details unclear, including the number of falls in each blood pressure group, the full methods used to record and verify falls, and whether the comparison accounted for other factors that could influence fall risk. Participants reported falls covering the previous 12 months, while the median follow-up was 350 days; the report does not fully explain the timing of those reports relative to blood pressure measurements.
Because the research is preliminary and the available material does not provide a full study paper or peer-reviewed results, the 70% figure should be read as a group comparison, not an individual’s forecast of fall risk. It does not establish that high home blood pressure alone caused falls or that lowering it would reduce them.
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Further Study and Clinical Review
The findings were presented at the American Heart Association’s Hypertension Scientific Sessions, held October 7–11, 2026. The supplied report does not state whether a full peer-reviewed paper is available or describe a planned follow-up study. Additional 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 supports home monitoring as part of blood pressure assessment and care. Wang encouraged older adults, family members, and caregivers to measure blood pressure regularly at home and share the results with a health care team. Readers should follow a clinician’s advice on how and when to measure, and should not change medication or treatment based on this preliminary report alone.
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Key Questions
What is masked high blood pressure?
It describes blood pressure that is not high in a medical office but is elevated at home. In this study, 15.4% of participants had that pattern.
How much higher was the reported fall rate?
The masked-high-blood-pressure group had a 70% higher fall rate than participants whose readings were high both in the office and at home. The report does not give the underlying group-specific fall rates, so the figure should not be treated as an individual prediction.
Does the study prove masked high blood pressure causes falls?
No. The preliminary study found an association, but it did not establish cause and effect or explain why the groups differed.
Should older adults monitor blood pressure at home?
The American Heart Association’s 2025 guideline recommends home monitoring to help confirm an office diagnosis and track blood pressure as part of care. People should discuss measurement and readings with a health care professional and not change treatment on their own.
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