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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 with high readings both at home and in medical offices. The study does not establish that masked hypertension causes falls, and researchers say the reasons for the association remain unclear.
A preliminary study of 758 adults older than 78 found that those 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 research, presented at the American Heart Association’s Hypertension Scientific Sessions in Arlington, Virginia, suggests that home readings may reveal information not captured by an office measurement, though it does not show that masked hypertension causes falls.
Researchers classified participants using blood pressure readings taken in medical offices and at home. 15.4% had masked high blood pressure, while 34.5% had high readings in both settings, a pattern described as sustained high blood pressure. Another 17.0% had higher readings in the office than at home, known as white coat high blood pressure, 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 comparison highlighted in the report was between people with masked hypertension and those with sustained hypertension: the masked group had a 70% higher rate of falls. The researchers also found that, when office and home readings were analyzed as a continuous measure, lower office blood pressure relative to home blood pressure was associated with a higher incidence of falls.
The fall history was self-reported, and the report describes the findings as preliminary research presented at a scientific meeting. The reported association does not establish that high blood pressure at home caused falls, or that changing blood pressure treatment would prevent them.
Why Home Readings May Matter
The findings draw attention to a possible blind spot in care for older adults: an office reading can appear normal even when blood pressure is higher at home. If that pattern is associated with falls, relying only on clinic measurements could leave some risk-related information unrecognized. The study’s authors say home readings may help clinicians assess blood pressure and inform care decisions, but the research does not establish how those readings should change treatment.
Falls are a major concern in later life. The 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 65 and older. A fall can threaten mobility and independence; however, this study did not test whether detecting masked hypertension or treating it reduces falls.
The results also complicate the familiar idea that low blood pressure is the main blood-pressure concern when considering falls. The report notes emerging evidence linking higher blood pressure at home with falls in older adults. This study adds an association to that discussion, rather than identifying a cause or offering proof of a prevention strategy.
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Office and Home Readings Compared
The American Heart Association’s 2025 adult blood pressure 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 research presented in 2026 is consistent with the guideline’s emphasis on readings outside the clinic, but the study itself does not show that monitoring alone changes health outcomes.
Masked hypertension refers to a pattern in which blood pressure is not high in the office but is elevated at home. It differs from sustained high blood pressure, where readings are high in both settings, and white coat high blood pressure, where readings are higher in the medical setting. These categories matter because a single office measurement may not capture how blood pressure varies in everyday life.
Study presenter Frances Wang, a researcher at Beth Israel Deaconess Medical Center in Boston, said home measurements can provide additional information for older adults and their care teams. The research was presented at the AHA meeting held in Arlington from October 7 to 11, 2026.
“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, Ph.D., M.S., study presenting author and researcher at Beth Israel Deaconess Medical Center
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Cause and Treatment Remain Unclear
The study found an association, but it does not explain why participants with masked hypertension reported more falls. Blood pressure variation or the body’s regulation of blood pressure during the day may be relevant, Watson said, but that is a possible explanation rather than a finding demonstrated by the analysis.
The report does not provide details needed to assess several questions, including whether other differences between the groups could account for some of the association, or whether treatment and other health factors affected fall rates. It also does not report whether participants’ falls were independently verified; the reported figure came from self-reported fall history. The research is preliminary, and the comparison does not establish that masked hypertension raises an individual’s fall risk by a predictable amount.
It remains unknown whether detecting masked high blood pressure and adjusting care based on home readings would reduce falls. The findings should not be read as advice to change medication or treatment without a clinician’s guidance.
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Further Research and Clinical Follow-Up
The findings were presented at the AHA’s 2026 Hypertension Scientific Sessions; the report does not announce a specific next study or publication milestone. Further research would need to examine why the patterns are associated and whether the relationship holds across other groups of older adults. Studies could also test whether using home readings in care plans affects fall rates, rather than only measuring whether readings and falls occur together.
Wang said older adults, family members and caregivers can share regular home readings with a health care team to help inform blood pressure and overall care planning. For individuals, what to monitor and how to respond to readings should be discussed with a health professional. Any decision about blood pressure treatment needs to account for the person’s circumstances and should not be based on this preliminary finding alone.
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Key Questions
What does masked high blood pressure mean?
Masked high blood pressure means readings are not high in a medical office but are elevated at home. Comparing both settings can reveal a pattern that a clinic reading alone may miss.
How much higher was the fall rate in the study?
Participants with masked high blood pressure had a 70% higher rate of falls than participants whose readings were high both in the office and at home. This is the study’s reported group comparison, not proof that masked hypertension caused falls.
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, and 23.4% reported at least one fall during the previous 12 months.
Does the study show that treating masked hypertension prevents falls?
No. The research reported an association and did not test whether detecting or treating masked hypertension prevents falls. The reason for the higher fall rate also remains unclear.
What should older adults do with home blood pressure readings?
The AHA recommends home monitoring to help confirm an office diagnosis and track blood pressure as part of an integrated care plan. Wang encouraged older adults and caregivers to share readings with a health care team; people should consult a clinician before changing treatment.
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