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A preliminary study presented at the American Heart Association’s 2026 Hypertension Scientific Sessions found adults older than 78 with masked high blood pressure had a 70% higher rate of falls than peers with high readings both at home and in medical offices. The observational findings do not show that masked hypertension causes falls, and the reasons for the association remain unclear.
Adults older than 78 with masked high blood pressure had a 70% higher rate of falls than peers whose blood pressure was high both in a medical office and at home, according to preliminary research presented at the American Heart Association’s 2026 Hypertension Scientific Sessions. The finding points to a possible role for home readings in identifying older adults who may otherwise appear to have normal blood pressure in clinic, but the study does not establish that masked hypertension causes falls.
The analysis included 758 adults older than 78, grouped according to blood pressure readings taken in medical and home settings. Researchers classified 15.4% as having masked high blood pressure, meaning readings were high at home but not in the office. Another 34.5% had sustained high blood pressure, with high 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 researchers also found that, when the difference between office and home readings was analyzed continuously, lower office blood pressure relative to home blood pressure was associated with a higher incidence of falls. The report describes the 70% comparison between the masked and sustained high blood pressure groups; it does not provide an absolute fall rate for each group in the supplied findings.
The research was presented at a scientific meeting and is described as preliminary. Frances Wang, the presenting author and a researcher at Beth Israel Deaconess Medical Center in Boston, said home measurements can offer information about blood pressure that office readings may miss. Karol E. Watson, a volunteer expert for the American Heart Association who was not involved in the study, said the analysis does not explain why the fall rate differed.
Why Home Readings May Matter
The findings matter because a blood pressure measurement taken at a clinic may not reflect what is happening at home. If the association is supported by further research, checking readings in both settings could help clinicians identify some older adults whose blood pressure pattern is not apparent during an office visit. It could add information to discussions about blood pressure management and falls, which can affect mobility and independence.
The study does not show that treating masked high blood pressure will prevent falls, or that the condition is the direct cause of them. The 70% figure is a relative comparison with participants who had high readings in both settings, not a measure of an individual’s chance of falling. Any implications for care need to be interpreted with a health professional and alongside other relevant factors.
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Office and Home Blood Pressure
Masked high blood pressure refers here to readings that are high at home but not in the medical office. That pattern can be missed if assessment relies only on a clinic measurement. White coat high blood pressure is the contrasting pattern in this study: readings are high in the office but not at home. Sustained high blood pressure means readings are high in both settings.
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 as part of an integrated care plan. The guideline recommendation is background to the study; it is not itself evidence that home monitoring 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, study presenting author and Beth Israel Deaconess Medical Center researcher
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Limits of the Fall Findings
The report identifies an association, not a cause-and-effect relationship. It does not establish whether masked high blood pressure contributes to falls, whether another factor helps explain both, or whether blood pressure variability is involved. Watson said the study did not explain why the fall rate was higher in the masked group.
The supplied findings also do not give the absolute fall rates for the masked and sustained high blood pressure groups, details about how falls were distributed across all four blood pressure categories, or whether the association remained after accounting for other possible influences. Falls were self-reported, and the follow-up was a median of 350 days. The research was preliminary and presented at a scientific meeting; further details and evaluation are needed.
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Further Study and Clinical Review
The findings will need to be examined in further research to establish whether the association holds in other groups of older adults and to investigate possible explanations. The report does not announce a planned follow-up study or a change to clinical guidance based on these results.
Wang encouraged older adults, relatives and caregivers to consider regular home blood pressure measurements and to share the readings with a health care team. The American Heart Association guideline likewise supports home monitoring as part of care. Decisions about blood pressure assessment or treatment should be made with a qualified health professional, who can interpret home and office readings together.
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Key Questions
What is masked high blood pressure?
In this study, it means blood pressure was high at home but not in the medical office. A clinic-only measurement may not capture that pattern.
How much higher was the reported fall rate?
The study reported a 70% higher rate of falls among participants with masked high blood pressure compared with those whose readings were high both at home and in the office. This is a relative comparison, not an absolute probability of falling.
Does the study prove masked high blood pressure causes falls?
No. The findings show an association and do not establish that masked high blood pressure caused falls. The reason for the difference remains unclear.
How many people took part?
The analysis included 758 adults older than 78. Over a median follow-up of 350 days, 23.4% reported at least one fall in the previous 12 months.
Should older adults monitor blood pressure at home?
The American Heart Association’s 2025 guideline recommends home monitoring for purposes including confirming an office diagnosis and tracking readings as part of a care plan. People should discuss their readings and care decisions with a qualified health professional.
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