Plate Nº 49 · recorded October 9, 2026
Health & Medicine ResearchReported finding
Masked High Blood Pressure Linked to 70% Higher Fall Risk in Adults Over 78
A study of 758 adults over 78 found that those with masked hypertension fell 70% more often than peers with consistently high readings. Researchers say home monitoring could catch the hidden risk.
By Elena Vasquez4 min read714 words
In brief
- Adults over 78 with masked hypertension showed 70% higher fall risk than those with sustained high blood pressure
- 758 adults over 78 took part; 15.4% had masked high blood pressure
- 23.4% of participants self-reported falling at least once in the prior 12 months
- Median follow-up was 350 days
- Study presented Oct. 7–11, 2026 at the AHA Hypertension Scientific Sessions in Arlington, Virginia
Older adults whose blood pressure reads normal in the clinic but elevated at home face a 70% higher risk of falling than peers whose readings run high in both settings, according to preliminary research presented October 7–11 at the American Heart Association's Hypertension Scientific Sessions 2026 in Arlington, Virginia.
The pattern, called masked hypertension, shows up only when patients check their blood pressure outside the doctor's office. In a group of 758 adults older than 78, those with masked high blood pressure fell far more often than the comparison group during roughly a year of follow-up.
"Preventing falls in older adults should be a top priority," said the study's presenting author, Frances Wang, Ph.D., M.S., 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 high blood pressure at home and risk of falls in older adults."
What did the study find?
The analysis divided participants into four blood pressure groups:
- Sustained high blood pressure (high in clinic and at home): 34.5%
- White-coat high blood pressure (high in clinic only): 17.0%
- Masked high blood pressure (normal in clinic, high at home): 15.4%
- Normal blood pressure (normal in both settings): 33.2%
Over a median follow-up of 350 days, 23.4% of participants—nearly 1 in 4—self-reported at least one fall in the previous 12 months. When researchers analyzed office and home readings continuously, lower office readings relative to home readings tracked with higher fall rates.
How big is the gap between masked and sustained high blood pressure?
Adults with masked high blood pressure fell 70% more often than those with sustained high blood pressure—an unusually large difference in a group already prone to falls.
Why might hidden high blood pressure raise fall risk?
The study does not establish cause. But Karol E. Watson, M.D., Ph.D., FAHA, an American Heart Association volunteer expert who was not involved in the research, sees a clue.
"This 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 (or not) throughout the day," said Watson, who holds the John Mazziotta, M.D., Ph.D., Chair of Medicine at the David Geffen School of Medicine at UCLA.
Unsteady blood pressure control across the day can produce dizziness on standing, a common trigger for falls in older adults. The team did not measure these orthostatic changes directly.
What do current guidelines recommend?
The findings line up with the American Heart Association's 2025 Joint Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. The guideline calls for annual blood pressure checks for every adult and recommends home monitoring to confirm diagnoses, track treatment and tailor care.
"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," Wang said. "We hope that older adults, their family members and caregivers will feel empowered to measure blood pressure regularly at home."
What are the study's limits?
Several caveats apply. Falls were self-reported, so participants may have under- or over-counted them. The cohort was small—758 people—and follow-up ran just under a year. Researchers also presented preliminary findings at a conference, so the work has not yet cleared peer review.
Wang framed the take-home cautiously: "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." The next step is testing whether treating masked hypertension actually lowers fall rates, not just correlates with them.
Watson added a final reminder: "These findings confirm that 'normal' office blood pressure isn't always the end of the story. Reducing the risk of falls should be a routine consideration, particularly in older adults with high blood pressure."
Falls are the leading cause of disability and functional decline in adults 65 and older, according to the U.S. Centers for Disease Control and Prevention.
via Medical Xpress (Source)
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