Adults older than 78 with masked high blood pressure face a 70% higher risk of falls compared to those with sustained high blood pressure, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2026 in Arlington, Virginia.
Masked hypertension occurs when blood pressure readings are normal in a medical office but elevated at home. The study, which analyzed 758 adults aged 78-98 from the Atherosclerosis Risk in Communities (ARIC) study, found that 15.4% of participants had masked hypertension, while 34.5% had sustained high blood pressure and 17.0% had white coat hypertension. Over a median follow-up of 350 days, nearly one in four participants (23.4%) reported falling at least once in the previous 12 months.
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. The findings 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.
"Preventing falls in elderly adults should be a top priority. 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," said Frances Wang, Ph.D., M.S., a researcher at Beth Israel Deaconess Medical Center in Boston and the study's presenting author. "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."
Karol E. Watson, M.D., Ph.D., FAHA, a volunteer expert for the American Heart Association who was not involved in the study, noted that the results challenge conventional thinking. "These findings confirm that 'normal' office blood pressure isn't always the end of the story," Watson said. "This deserves a closer look because falls can often accelerate decline in both physical and mental function for patients when physical independence is lost."
The study's implications are significant for older adults, their families, and healthcare providers. With home blood pressure monitoring becoming more accessible, integrating home readings into routine care could help identify hidden risks and prevent falls. The American Heart Association provides resources such as Health Threats from High Blood Pressure and Understanding Blood Pressure Readings to help patients manage their condition.
The abstract will be presented at 11:45 a.m. ET on Friday, October 9, 2026, and will be published in the Hypertension Scientific Sessions 2026 Supplement of the Hypertension journal on November 17, 2026. The study was funded by the American Heart Association and the National Institutes of Health.
As the population ages, understanding the link between masked hypertension and falls becomes increasingly critical. Home blood pressure monitoring offers a simple, effective tool to detect masked hypertension and potentially reduce fall risk. For more information, visit heart.org or stroke.org.
