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The Hidden Danger of “Masked” High Blood Pressure in Older Adults

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This Clinical Trial Offered New Hope for Uncontrolled High Blood Pressure; masked high blood pressure

Monitoring blood pressure at home could help prevent a life-altering injury for some seniors, a new study warns.

Seniors older than 78 with “masked” high blood pressure have a 70 percent higher risk of falls than those who’ve been properly diagnosed, according to results presented at the American Heart Association’s annual meeting on hypertension.

Researchers said masked high blood pressure involves seniors’ readings appearing normal at a doctor’s office but consistently high at home.

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“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,” lead investigator Frances Wang said in a news release. She is a researcher at Beth Israel Deaconess Medical Center in Boston.

What Did the Study Find?

Changes in blood pressure can increase fall risk by causing dizziness or fainting, according to the American Heart Association (AHA).

The findings were based on data from more than 750 older adults who participated in a long-term heart disease risk study. The participants were between 78 and 98 years old.

Researchers also compared falls among people with “masked” high blood pressure to those of patients with “white coat” high blood pressure. “White coat” blood pressure readings are high at a doctor’s office but low when measured at home.

Among the participants, 17 percent had white coat high BP, 15 percent had masked high BP, and 33 percent had normal blood pressure readings.

For each person, multiple blood pressure readings were taken at home and in a doctor’s office.

After about a year, nearly one in four people (23 percent) had fallen at least once, researchers said.

People with masked high blood pressure had a 70 percent higher rate of falls, while those with white coat high BP had a 39 percent lower risk of falls.

“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 and share this data with their health care team to help inform their blood pressure and overall healthcare plan.”

AHA volunteer expert Dr. Karol Watson agreed that the study 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 for patients when physical independence is lost,” Watson, chair of medicine at the David Geffen School of Medicine at UCLA, said in a news release.

RELATED: Can Personalized Telehealth Help Black Patients Control High Blood Pressure?

Study Limitations

“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,” Watson said. “Reducing the risk of falls should be a routine consideration, particularly in older adults with high blood pressure.”

Researchers presented their findings Oct. 9 at the AHA meeting, which took place in Arlington, Virginia. Results reported at medical meetings should be considered preliminary until published in a peer-reviewed journal.

Why High Blood Pressure Matters in the Black Community

According to the AHA, Black adults are more likely to develop high blood pressure and often develop it earlier in life. If left unmanaged, high blood pressure may lead to health complications, such as stroke, heart disease, kidney disease, and cognitive decline.

Because high blood pressure is so common, hidden or masked high BP could increase risks that often go unnoticed. For Black adults who already face a higher burden of hypertension-related illnesses, recognizing hidden blood pressure problems may be especially important.

ATTR-CM clinical trial
Photo by Tim Robberts/Getty Images

How Could High Blood Pressure Increase Fall Risk?

High blood pressure can affect blood vessels and circulation. The condition may contribute to balance problems, dizziness, or reduced physical function. Falls are a major concern for older adults, and the Centers for Disease Control and Prevention (CDC) reports that more than one in four older adults falls each year. Just one fall can impact an older adult’s independence and quality of life, underscoring the need for health monitoring, including blood pressure control.

4 Signs Your Blood Pressure May Not Be As Well Controlled As You Think

Below are some potential signs of uncontrolled blood pressure:

  • Blood pressure varies widely throughout the day.
  • You have normal readings at the doctor’s office but elevated readings at home.
  • You have a history of high blood pressure but haven’t monitored it recently.
  • You experience dizziness, balance issues, or unexplained fatigue.

High blood pressure is often asymptomatic, meaning it can have no symptoms. This is why regular monitoring is so important.

RELATED: This Clinical Trial Offers New Hope for Uncontrolled High Blood Pressure

Clinical Trials and Blood Pressure Research

Researchers continue to study how high blood pressure affects different populations. Clinical trials can help identify better ways to detect hidden high blood pressure and reduce complications.

Greater Black participation in medical research could help researchers and healthcare professionals ensure that treatments and monitoring strategies work for diverse communities. Clinical trials play an important role in improving how high blood pressure is diagnosed, monitored, and treated. Increased participation from Black patients can help researchers better understand cardiovascular risks across diverse communities.

If you’d like to learn more about clinical trials, visit BlackDoctor’s Clinical Trials Resource Center.

More information

The American Heart Association has more on heart problems and fall risk among seniors.

SOURCE: American Heart Association, news release, Oct. 9, 2026

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