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 high blood pressure at home but not in the clinic had a 70% higher rate of falls than peers with high readings in both settings. The study shows an association, not that masked high blood pressure causes falls, and researchers say the reasons for the link remain unknown.
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 2026. The finding suggests home readings may reveal blood pressure patterns not captured during clinic visits, though the study does not establish that those patterns cause falls.
The study included 758 adults older than 78. Researchers classified 15.4% as having masked high blood pressure, meaning readings were high at home but not in the office. By comparison, 34.5% had sustained high blood pressure, with elevated readings in both settings; 17.0% had white coat high blood pressure, with higher office readings; and 33.2% had normal readings in both settings.
Over a median follow-up of 350 days, 23.4% of participants reported having fallen at least once during the previous 12 months. The report says the comparison between blood pressure groups found a higher fall rate among participants with masked high blood pressure than among those with sustained high blood pressure. It also reports that, when office and home readings were assessed as continuous measures, lower office readings relative to home readings were associated with more falls.
The research was presented as preliminary findings at the meeting in Arlington, Virginia, held October 7–11. Frances Wang, Ph.D., M.S., the presenting author and a researcher at Beth Israel Deaconess Medical Center in Boston, said home measurements can help identify high blood pressure that may be missed in the office. The study report does not show that home monitoring or a change in treatment prevents falls.
Why Home Readings May Matter
Blood pressure assessments based only on clinic measurements may not capture what happens at home. The findings suggest that, for some adults over 78, comparing readings from both settings could give health care teams additional information when assessing blood pressure and fall risk. This may be relevant because falls are a major cause of disability and functional decline among adults 65 and older, according to the U.S. Centers for Disease Control and Prevention.
Wang said regular home readings could help patients and caregivers share more information with clinicians. However, the research does not establish a reason for the observed association, nor does it show that treating masked high blood pressure reduces falls. The results point to a possible consideration for clinical assessment, not a proven fall-prevention approach.
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How the Study Classified Blood Pressure
The researchers compared blood pressure measurements taken in medical offices and at home. In this study, masked high blood pressure described participants whose readings were high at home but not in the office. Sustained high blood pressure meant readings were high in both settings, while white coat high blood pressure referred to higher readings in the office than at home.
The American Heart Association’s 2025 blood pressure 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 care over time as part of an integrated plan. The guideline provides broader clinical context; it is not evidence that home monitoring itself prevents falls.
Karol E. Watson, M.D., Ph.D., a volunteer expert for the American Heart Association who was not involved in the study, said the findings fit the idea that a normal office reading does not always reflect a person’s readings at home. She said falls may accelerate physical and mental decline when independence is lost, but stressed that the study does not explain why participants with masked high blood pressure had more falls.
“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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What the Findings Cannot Explain
The report describes an association, not proof of cause and effect. It does not explain why the group with masked high blood pressure had a higher rate of falls, or whether blood pressure variability, difficulty regulating blood pressure, or other factors contributed. Watson said those possibilities may merit closer study, but the findings do not determine which explanation is correct.
The fall measure also relied on participants’ reports that they had fallen at least once during the previous 12 months. The report gives a median follow-up of 350 days but does not specify the exact timing of each fall in relation to the blood pressure measurements. It does not provide enough detail to establish whether the association applies to older adults outside the study group or to show how changes in blood pressure care would affect fall rates.
The presentation was described as preliminary research. Further evidence would be needed to assess the result, clarify the mechanisms involved and determine whether using home readings to guide care changes outcomes.
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Further Study and Clinical Follow-Up
The study was presented at the American Heart Association’s 2026 Hypertension Scientific Sessions. The report does not announce a planned follow-up trial or provide a timeline for additional results, so the next research milestones are not clear.
For now, Wang encouraged older adults, family members and caregivers to consider regular home blood pressure measurements and share the readings with a health care team. The American Heart Association guideline recommends home monitoring as part of an integrated plan, but patients should discuss how to measure and interpret readings with their clinician rather than changing treatment based on this preliminary study alone.
Researchers will need to investigate why home and office readings differed in participants who fell and whether that pattern predicts falls in other groups. Until then, the reported link can inform questions for clinical discussion, but it should not be treated as evidence that masked high blood pressure inevitably leads to a fall.
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Key Questions
What does masked high blood pressure mean in this study?
It means a participant had high blood pressure readings at home but not in the medical office. The study compared this group with people whose readings were high in both settings, among other categories.
How much higher was the fall rate?
The study report says adults older than 78 with masked high blood pressure had a 70% higher rate of falls than those with high readings both in the office and at home. This is a comparison between groups, not evidence that masked high blood pressure caused the falls.
How many people took part, and how long were they followed?
The research included 758 adults older than 78. Median follow-up was 350 days. During that period, 23.4% reported at least one fall during the previous 12 months.
Does the study show that home monitoring prevents falls?
No. The study examined associations between blood pressure patterns and falls; it did not test whether home monitoring or a treatment change reduces fall risk. The researchers say home readings can add information for clinical assessment.
What should older adults do with this information?
Wang encouraged older adults and caregivers to share regular home blood pressure readings with a health care team. People should ask a clinician how to take and interpret readings and should not change medication based solely on this preliminary research.
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