A study presented at the American Heart Association's Hypertension Scientific Sessions 2026 reveals that older adults with masked high blood pressure—normal blood pressure in the doctor's office but elevated readings at home—face a 70% higher risk of falls compared to those with sustained high blood pressure (high readings both in and out of the office). The findings, which are preliminary and have not yet been peer-reviewed, could change how clinicians assess fall risk in the elderly and highlight the critical role of home blood pressure monitoring.
Falls are the leading cause of disability and functional decline in adults age 65 and older, according to the U.S. Centers for Disease Control and Prevention. While low blood pressure is a known fall risk, emerging evidence suggests that high home blood pressure may also contribute. The study, which included 758 adults aged 78-98, found that among participants, 34.5% had sustained high blood pressure, 17.0% had white coat hypertension, 15.4% had masked hypertension, and 33.2% had normal readings. Over a median follow-up of 350 days, nearly one in four participants reported falling at least once in the previous year. Notably, lower office blood pressure relative to home blood pressure was associated with a higher incidence of falls.
"Preventing falls in elderly adults should be a top priority," said Frances Wang, Ph.D., M.S., the study's presenting author and a researcher at Beth Israel Deaconess Medical Center in Boston. "These findings highlight that, in addition to office blood pressure measurement, home blood pressure readings can be an important way to identify hidden home high blood pressure and risk of falls in older adults." Wang emphasized that home monitoring can empower older adults and their caregivers to take an active role in managing health.
The results align with the American Heart Association's 2025 Joint Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, which recommends annual blood pressure monitoring and home monitoring to confirm diagnoses and tailor care. Karol E. Watson, M.D., Ph.D., FAHA, a volunteer expert for the American Heart Association, noted that the study "doesn't explain why the fall risk was higher, but it may be telling us something about blood pressure variability and how well older adults are able to regulate their blood pressure throughout the day."
With home blood pressure monitors becoming more accessible, the findings suggest that routine home monitoring could help identify older adults at hidden risk for falls, allowing for earlier interventions. As Wang stated, "Home blood pressure measurement can add helpful health information for older adults and, as shown in findings from prior studies, for most of the general public." The study was funded by the American Heart Association and the National Institutes of Health.
For more information on high blood pressure and its health threats, visit the American Heart Association's resources on Health Threats from High Blood Pressure and Understanding Blood Pressure Readings. Additional tools can be found at Find High Blood Pressure Tools and Resources. The abstract will be published in the Hypertension Scientific Sessions 2026 Supplement of the Hypertension journal.
