Adults older than 78 with masked high blood pressure—normal readings 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 in both settings, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2026. The findings underscore the potential of home blood pressure monitoring to identify hidden fall risks in a rapidly growing, under-studied population.
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 traditionally considered a fall risk factor, emerging evidence suggests that high home blood pressure may also contribute to falls. The study’s 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 for all adults and home monitoring to confirm office diagnoses and tailor care.
“Preventing falls in elderly adults should be a top priority,” said Frances Wang, Ph.D., M.S., presenting author and 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.”
The study analyzed 758 adults aged 78-98 from the Atherosclerosis Risk in Communities (ARIC) study, with a median age of 83 and 59% women. Among them, 34.5% had sustained high blood pressure, 17.0% had white coat hypertension, 15.4% had masked hypertension, and 33.2% had normal readings. During a median follow-up of 350 days, 23.4% reported at least one fall in the previous 12 months. Lower office blood pressure relative to home blood pressure was associated with a higher incidence of falls.
“Our analysis indicates that home blood pressure monitoring provides valuable information for clinical assessment, can help guide treatment decisions and may identify patients with hidden fall risk,” Wang said. “This information can be particularly important to incorporate into patient care since falls are a major cause of disability and loss of independence among older adults.”
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 findings reveal important nuances. “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.” Watson is the John Mazziotta, M.D., Ph.D., Chair of Medicine at the David Geffen School of Medicine at UCLA.
The study’s implications extend to clinical practice, suggesting that integrating home blood pressure data could improve fall risk assessment and management in older adults. As home monitoring becomes more accessible, it may empower patients and caregivers to take proactive steps. For more information on blood pressure health, see the American Heart Association’s resources on Health Threats from High Blood Pressure and Understanding Blood Pressure Readings. Additional tools are available at Find High Blood Pressure Tools and Resources.
The research was funded by the American Heart Association and the National Institutes of Health. The abstract will be published in the Hypertension Scientific Sessions 2026 Supplement of the Hypertension journal. The original release is available at www.newmediawire.com.
