Key result
Mean home systolic BP is not associated with falls in older adults with treated hypertension.
Why the study?
Concerns regarding hypotension and excessive blood pressure variability causing falls can impede reaching blood pressure goals in older adults, whereas home blood pressure monitoring may permit better management while avoiding falls.
Do home blood pressure monitoring parameters (mean systolic BP, white coat effect, day-to-day variability) associate with the risk of falls in older adults with treated hypertension?
Cohort (n=541)
Do home blood pressure monitoring parameters (mean systolic BP, white coat effect, day-to-day variability) associate with the risk of falls in older adults with treated hypertension?
Home blood pressure monitoring parameters, including mean systolic BP, white coat effect, and day-to-day variability, were not associated with an increased risk of falls in older adults with treated hypertension.
Answers are grounded in this paper and cite their sources.
Clinicians should not rely on home BP measures for falls risk assessment; leaves open their utility to guide safer BP management in older adults.[[1]](https://www.sciencedirect.
Background: Concerns about hypotension and excessive blood pressure (BP) variability leading to falls may be a barrier to achieving BP treatment goals among older adults. Home BP monitoring (HBPM) may allow for better BP management while avoiding falls. Methods: = 541), were instructed in proper HBPM technique and asked to take 2 morning and 2 evening readings for 7 days. Among 499 participants with ≥4 days of HBPM, white coat effect was defined as mean clinic BP minus mean BP on HBPM. Day-to-day variability was calculated using standard deviation independent of the mean (SDIM). Participants reported falls monthly for 1 year. We estimated hazard ratios (HRs) for falls across quartiles of systolic BP on HBPM, white coat effect and SDIM, separately, adjusting for demographic characteristics and chronic conditions. Results: The mean ± SD age of participants was 74.2 ± 6.1 years, and 57.3% were women. Prefrailty and frailty prevalence were 50.7% and 3.4%, respectively. Participants in the highest versus lowest quartile of mean SBP from HBPM were older and more frequently male. Over 379 person-years, 187 participants reported falls. Comparing the highest and lowest quartiles, the HRs (95% confidence interval) were 0.85 (0.53-1.37), 0.84 (0.51-1.40), and 0.97 (0.62-1.51) for mean systolic BP, white coat effect, and SDIM, respectively. There was no evidence of associations between these measures for diastolic BP and falls. Conclusion: BP measured using HBPM was not associated with falls among older US adults with treated hypertension.
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Poudel et al. (2026) conducted a cohort in Hypertension (n=541). Home blood pressure monitoring (HBPM) vs. Lowest quartile of HBPM metrics was evaluated on Falls (HR 0.85, 95% CI 0.53-1.37). Mean systolic blood pressure measured by home monitoring was not associated with the risk of falls among older adults with treated hypertension (HR 0.85; 95% CI 0.53-1.37 for highest vs lowest quartile).
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