THE ARISING · Longevity & Healthspan
Hidden High Blood Pressure Found Only at Home Linked to 70% More Falls After 78
A normal blood pressure reading at the doctor's office may not tell the whole story for people in their late seventies and beyond. In a preliminary study of 758 older adults, those whose office readings were normal but whose home readings were high had about a 70% higher risk of falling than those whose readings were high in both places.
This is an observational study in people, so it shows an association, not a cause. It was presented as a research abstract at the American Heart Association's Hypertension Scientific Sessions 2026 on October 9. It has not been peer reviewed or published in a journal. The details here come from the American Heart Association Newsroom's release on the study.
The pattern is called masked hypertension. Blood pressure looks normal in a clinic but runs high at home. Its mirror image is "white coat" hypertension, where readings are high at the clinic but lower at home. Sustained hypertension means readings are high in both settings.
According to the newsroom release, the participants came from the Atherosclerosis Risk in Communities (ARIC) study, which began enrolling people in 1985 in four U.S. communities. They were aged 78 to 98, with a median age of 83. About 59% were women and 17% identified as Black. Some 82% were already taking blood pressure medication. Office blood pressure was measured three times after five minutes of seated rest. Home readings were taken morning and evening on eight nonconsecutive days in 2023.
Of the 758 adults, 34.5% had sustained high blood pressure, 17.0% had white coat hypertension, 15.4% had masked hypertension and 33.2% had normal readings. Participants reported their falls during annual phone calls. Over a median follow-up of 350 days, 23.4% said they had fallen at least once in the previous 12 months.
Masked hypertension was linked to a 70% higher fall risk than sustained hypertension. White coat hypertension was linked to a lower fall risk than high readings in both settings. When the researchers treated the gap between office and home readings as a continuous measure, a lower office reading relative to the home reading went with more falls.
That may seem backwards. Low blood pressure is usually seen as the fall risk. Karol E. Watson, M.D., Ph.D., of UCLA, who was not involved, told the newsroom the study "doesn't explain why the fall risk was higher." She said it may point to blood pressure variability and how well older adults regulate their pressure through the day. That is her interpretation, not a finding.
The study is background for current advice. The 2025 joint guideline on high blood pressure, published in Circulation, replaces the 2017 version. The part of the guideline we could see, the study, describes it as a "living, working document" for clinicians. According to the AHA newsroom, the guideline recommends annual blood pressure checks for all adults. It also recommends home monitoring to help confirm an office diagnosis and to guide care.
There are limits. Falls were self-reported. The study followed people for under a year. It cannot show that treating masked hypertension would prevent falls. "Home blood pressure measurement can add helpful health information for older adults," said presenting author Frances Wang, Ph.D., of Beth Israel Deaconess Medical Center. She hopes patients will share home readings with their health care team.
The next step is publication of the full analysis in a peer-reviewed journal. That will show how the numbers were calculated and whether other groups find the same pattern.
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