Objective: Blood pressure (BP) recovery after orthostatic hypotension might be important to prevent cerebral hypoperfusion episodes in older adults, and be related to better clinical outcome. The objective was to study the relationship between BP recovery and clinical outcome, that is physical and cognitive performance, frailty and falls, in geriatric outpatients. Methods: One hundred and sixty-eight geriatric outpatients underwent continuous (beat-to-beat) BP measurements during standing up, and a comprehensive geriatric assessment, including assessment of physical performance (chair stand test), cognitive performance (Mini Mental State Examination), frailty (Fried criteria) and falls in the previous year. BP recovery was evaluated at 15–30, 30–60, 60–120 and 120–180 s after standing up and defined as mean SBP and DBP in the respective time intervals minus baseline BP. Associations with clinical outcome were assessed using linear (physical and cognitive performance and frailty) and logistic (falls) regression, adjusting for age, sex, baseline BP and initial BP drop. Results: SBP recovery was associated with frailty (30–60 s interval; β = 0.013, P = 0.02) and falls (30–60 s interval; odds ratio = 1.024, P = 0.02). DBP recovery was associated with physical performance (30–60 s interval; β = 0.215, P = 0.01), frailty (30–60 s interval; β = 0.028, P = 0.02) and falls (30–60 s interval; odds ratio = 1.039, P = 0.04). Neither SBP nor DBP recovery was associated with cognitive performance. Conclusion: DBP recovery was particularly associated with clinical outcome in geriatric outpatients, suggesting BP recovery to be of clinical interest.

Background The relationship between orthostatic hypotension and clinical outcome in older adults is poorly understood. Blood pressure drop rate (ie, speed of blood pressure drop) may particularly reflect the imposed challenge to the baroreflex and the associated clinical outcome (ie, frailty and number of falls). This study aimed to compare orthostatic blood pressure drop rate and drop magnitude with regard to their association with frailty and number of falls. Methods and Results Blood pressure was measured continuously during a standardized active stand task in 168 patients (mean age 81.4±7.0; 55.4% female) who visited a geriatric outpatient clinic for cognitive or mobility problems. The association of orthostatic blood pressure drop rate, blood pressure drop magnitude, and baroreflex sensitivity (ie, increase in heart rate divided by systolic blood pressure drop magnitude) with frailty (Fried criteria and 4 frailty markers) and self‐reported number of falls was assessed using linear regression models, adjusting for age and sex. Systolic blood pressure drop rate had the strongest association with frailty according to the 4 frailty markers (β 0.30; 95% CI , 0.11–0.49; P =0.003) and number of falls (β 1.09; 95% CI , 0.19–1.20; P =0.018); diastolic blood pressure drop magnitude was most strongly associated with frailty according to the Fried criteria (β 0.37; 95% CI , 0.15–0.60; P <0.001). Baroreflex sensitivity was associated with neither frailty nor number of falls. Conclusions Orthostatic blood pressure drop rate was associated with frailty and falls and may reflect the challenge to the baroreflex rather than drop magnitude.