TL;DR
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A preliminary study of 758 adults older than 78 found that those with masked high blood pressure—normal readings in medical settings but high readings at home—had a 70% higher rate of falls than participants with high readings in both settings. The research found an association, not proof that masked hypertension causes falls, and the reasons for the link remain unclear.
A preliminary study of 758 adults older than 78 found that participants 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 settings. The findings, presented at the American Heart Association’s Hypertension Scientific Sessions 2026, point to home readings as a possible way to identify risk that office measurements alone may miss; they do not show that masked hypertension causes falls.
Masked high blood pressure refers to a pattern in which readings are normal in a medical office but high outside it, including at home. In the study, 15.4% of participants had this pattern. Another 34.5% had sustained high blood pressure, meaning 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.
Participants were followed for a median of 350 days. Nearly one in four—23.4%—reported having fallen at least once in the previous 12 months. The researchers also found 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 supplied report does not give the fall rate for each group or further details about how falls were verified.
Presenting author Frances Wang, a researcher at Beth Israel Deaconess Medical Center in Boston, said home measurements can help identify hidden high blood pressure and inform care. The research is preliminary conference work, and the report does not describe it as proof of a cause-and-effect relationship. The study’s results were presented at the American Heart Association meeting in Arlington, Virginia, held October 7–11, 2026.
Why Home Readings May Matter
Blood pressure readings taken in a clinic may not capture a person’s usual levels outside that setting. The reported association suggests that home monitoring could add information when clinicians assess older adults whose office readings appear normal, particularly when considering falls and changes in independence. It does not establish that monitoring itself prevents falls or that lowering blood pressure would reduce them.
Falls are a major health concern in later life. The source report cites the U.S. Centers for Disease Control and Prevention, which identifies falls as the leading cause of disability and functional decline among adults aged 65 and older. A fall can also affect a person’s ability to live independently. The study therefore draws attention to a possible risk marker in a group for whom the consequences of falls can be substantial.
The finding may also complicate the familiar assumption that low blood pressure is the only blood-pressure pattern relevant to falls. American Heart Association volunteer expert Karol E. Watson, who was not involved in the study, said the result merits closer examination. Her explanation that blood pressure variability or the body’s ability to regulate pressure could be relevant is a possibility, not a mechanism demonstrated by this research.
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How the Study Classified Blood Pressure
The researchers separated participants into four groups by comparing office and home measurements. Sustained high blood pressure meant elevated readings in both settings. Masked high blood pressure meant a normal office reading alongside a high home reading. White coat high blood pressure described the reverse pattern, while the normal group had readings that were not high in either setting.
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 and progress as part of an integrated care plan. The guideline is broader than this study and does not mean the new findings establish a fall-prevention strategy.
The report notes earlier evidence associating high home blood pressure with more falls in older adults, despite low blood pressure often being considered a fall risk. The new analysis adds findings from adults older than 78, but its conference presentation and preliminary status mean the results should be interpreted as an association requiring further study.
“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 Fall Rates Still Unknown
The study found an association, but it does not establish that masked high blood pressure caused more falls. The supplied report does not explain why the link appeared. Watson suggested that blood pressure variability or differences in how well people regulate blood pressure throughout the day might be relevant, but those remain possible explanations rather than demonstrated findings.
Several details needed to judge the result are not included in the report: the number of falls in each blood pressure group, the statistical uncertainty around the reported 70% difference, and whether factors such as health conditions, medication, mobility, or prior falls were accounted for. The report says falls were self-reported and that nearly one in four participants reported a fall during the previous 12 months; it does not clarify whether all reports referred to falls during follow-up or provide further detail on timing.
The participants were all older than 78, so the findings cannot automatically be applied to younger adults. The study was presented as preliminary research at a scientific meeting, and the available material does not provide enough information to assess the full methods or whether results have undergone peer-reviewed publication. No treatment change or clinical outcome from using home readings was reported.
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Further Study and Clinical Review
The immediate next step is further research to determine whether the association holds in larger or different groups of older adults and to clarify how blood pressure patterns relate to falls over time. More detailed results, including group-specific fall rates and the analysis behind the 70% comparison, would help readers and clinicians assess the finding.
Wang said older adults, family members, and caregivers could measure blood pressure at home regularly and share the readings with a health care team. That reflects the study author’s recommendation and the existing guideline’s support for home readings as part of care; it is not evidence that monitoring alone prevents falls. Decisions about blood pressure or fall risk should be discussed with a qualified health professional, who can consider an individual’s overall health and measurements.
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Key Questions
What does masked high blood pressure mean?
It means blood pressure is normal in a medical office but high at home or in other settings outside the clinic. Comparing measurements from both settings can reveal a pattern that an office reading may not show.
How much higher was the reported fall risk?
Adults older than 78 with masked high blood pressure had a 70% higher rate of falls than participants whose blood pressure was high both at home and in medical settings. The report does not provide the underlying fall rates for the two groups, so the absolute difference cannot be determined from the supplied information.
Does the study prove masked high blood pressure causes falls?
No. The study reported an association, not proof of cause and effect. It also did not establish why the groups had different fall rates.
How many people took part, and how long were they followed?
The study included 758 adults older than 78. The median follow-up was 350 days. Nearly one in four participants reported at least one fall during the previous 12 months, according to the report.
What should older adults do with home readings?
The study’s presenting author encouraged older adults and caregivers to share home blood pressure readings with a health care team. Home monitoring is also recommended in the American Heart Association’s guideline as part of care, but this study does not show that monitoring prevents falls. People should discuss readings and care decisions with a qualified health professional.
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