Objective To determine the effect of frailty on the prognosis in the elderly hypertensive patients. Methods A total of 314 elderly hypertension patients who visited the Outpatient Department or took physical examination in our hospital from March 2015 to October 2016 were enrolled in this study. Their general demographic characteristics and medical history were collected by questionnaires. The comorbid conditions were evaluated with Charlson comorbidity index (CCI). Mini nutritional assessment-short form (MNA-SF) was used for nutritional assessment, and Barthel index for daily life ability. According to the state of weakness, they were divided into normal (n=65), pre-frialty (n=208) and frialty groups (n=41). Based on the occurrence of falls during the 18 months′ follow-up, the patients were also assigned into fall group (n=41) and non-fall group (n=273), and into hospitalization group (n=133) and non-hospitalization group (n=181) according to all-cause hospitalization. SPSS statistics 19.0 was used for data processing. Student′s t test or Chi-square test was employed for intergroup comparison with different data types. The factors with signi-ficant difference by univariate analysis were further analyzed by multivariate logistic regression analysis to identify independent risk factors. Results Fried standard identified 41 frail patients out of the 314 subjects, with a detection rate of 13.1%, and the rate was increased with age. After adjustment, the regression model showed that pace reduction was associated with increased risk for fall (OR=2.88, 95%CI 1.26-6.56, P<0.05), but not with all-cause hospitalization (OR=1.13,5%CI 0.57-2.22, P=0.726). Conclusion The prevalence of frailty in elderly hypertensive patients is increased with age. Pace reduction is an independent risk factor for incidence of fall in them.