The active postural "squat-stand" test can be used to assess baroreflex homeostasis by continuously monitoring changes in blood pressure (BP) and heart rate (HR) using a FinapresR device. The standing to squatting transition is accompanied by rises in BP and pulse pressure (PP) and by a reflex reduction in HR. Conversely, the squatting to standing transition imposes a major orthostatic stress, with a marked immediate drop in BP followed by both reflex tachycardia and vasoconstriction leading to a rapid return of BP and HR to baseline values. These ample mirror changes in BP and HR, mimicking those observed with the classical pharmacological approach using vasopressor/vasodilating agents, allow the calculation of the so-called baroreflex gain (BRG), by plotting R-R intervals according to systolic BP levels during the squat-stand transition. In healthy subjects, BRG was reduced with aging (69 years : 2.04 vs 31 years : 3.63 msec.mm Hg-1; p=0.0006), was not affected by gender (women : 3.64 vs men : 3.42 msec.mm Hg-1; p=0.55) and was slightly dampened in overweight people (BMI 29 kg/m² : 2.85 vs BMI 22 kg/m² : 4.03 msec.mm Hg-1; p=0.03). In various pathological conditions, especially in diabetes with cardiovascular autonomic neuropathy (CAN), both the increase in BP and PP (greater pulsatile stress) during squatting and the BP reduction during standing (orthostatic hypotension) may be more important and sustained. Type 1 diabetic patients with CAN had lower GBR compared to aged-matched patients without CAN (1.39 vs 2.43 msec.mm Hg-1; p=0.0374) and more prolonged orthostatic hypotension. Several drugs (i.e. antihypertensive compounds, psychotropic agents) may also alter baroreflex homeostasis and aggravate orthostatic hypotension. GBR calculated during a squat-stand test was not affected by monotherapy with angiotensin converting enzyme inhibitors in diabetic patients, whereas it was significantly reduced by tricyclic antidepressants in nondiabetic individuals.