New preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2026 reveals that older adults with masked high blood pressure—normal readings in the doctor's office but elevated at home—face a 70% higher risk of falls compared to those with sustained high blood pressure. The study, which included 758 adults aged 78 to 98, underscores the critical role of home blood pressure monitoring in identifying hidden risks and preventing falls, a leading cause of disability in older adults.
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, emerging evidence points to high home blood pressure as a significant factor. The study found that 15.4% of participants had masked hypertension, and nearly one in four reported falling at least once during the follow-up period. Notably, white coat hypertension—high office readings but normal at home—was associated with a lower fall risk.
"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 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'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 monitoring and home blood pressure tracking to tailor care.
Karol E. Watson, M.D., Ph.D., FAHA, a volunteer expert for the American Heart Association, emphasized the implications: "These findings confirm that 'normal' office blood pressure isn't always the end of the story. This deserves a closer look because falls can often accelerate decline in both physical and mental function." Watson, who was not involved in the study, noted that the reasons for the higher fall risk remain unclear but may involve blood pressure variability.
The study analyzed data from the community-based Atherosclerosis Risk in Communities (ARIC) study, with participants taking multiple blood pressure readings both in clinics and at home over eight days. The findings are considered preliminary until published in a peer-reviewed journal. The abstracts will be available in the Hypertension Scientific Sessions 2026 Supplement of the Hypertension journal.
For older adults, regular home monitoring can provide essential data to share with healthcare teams. As Wang noted, "Home blood pressure measurement can add helpful health information for older adults... We hope that older adults, their family members and caregivers will feel empowered to measure blood pressure regularly at home." The American Heart Association offers resources such as Health Threats from High Blood Pressure and Understanding Blood Pressure Readings to help the public manage their health. Additionally, Find High Blood Pressure Tools and Resources provides practical tools for monitoring. More information is available at heart.org and stroke.org.
