Table 3

Factors significantly associated with the development of hypotension in patients newly diagnosed with heart failure

	Controls (n=5102)		Cases with hypotension (n=2551)		OR*	95% CI
	n	%	n	%	OR*	95% CI
Lifestyle factors
BMI (kg/m²)
11–19.99	221	4.3	155	6.1	1.20	0.94 to 1.54
20–24.99	1137	22.3	691	27.1	1	–
25–29.99	1701	33.3	817	32.0	0.76	0.66 to 0.88
≥30	1560	30.6	670	26.3	0.64	0.55 to 0.74
Unknown	483	9.5	218	8.5	0.73	0.59 to 0.90
Healthcare utilisation
PCP visits†
0–3	105	2.1	17	0.7	1	–
4–9	771	15.1	208	8.2	1.32	0.76 to 2.30
≥10	4226	82.8	2326	91.2	2.29	1.34 to 3.90
Referrals†
None	1022	20.0	355	13.9	1	–
1–3	1900	37.2	873	34.2	1.20	1.02 to 1.41
≥4	2180	42.7	1323	51.9	1.41	1.20 to 1.65
Hospitalisations†
None	3487	68.3	1409	55.2	1	–
≥1	1615	31.7	1142	44.8	1.53	1.37 to 1.71
Cardiovascular comorbidities‡
Hypotension antecedents	160	3.1	210	8.2	2.32	1.84 to 2.92
1 episode	131	2.6	155	6.1	2.09	1.61 to 2.71
≥2 episodes	29	0.5	55	2.1	3.31	2.06 to 5.34
Ischaemic heart disease	2940	57.6	1688	66.2	1.36	1.22 to 1.53
Myocardial infarction	1519	29.8	1009	39.6	1.35	1.20 to 1.52
Stable angina	1671	32.8	967	37.9	1.14	1.01 to 1.28
Unstable angina	363	7.1	269	10.5	1.25	1.03 to 1.52
Valvular cardiac disease	612	12.0	378	14.8	1.19	1.03 to 1.38
Hyperlipidaemia	1419	27.8	800	31.4	1.15	1.02 to 1.30
Hypertension	3080	60.4	1255	49.2	0.59	0.52 to 0.66
Other specific comorbidities‡
Renal failure§
No (eGFR >60 mL/min/1.73 m²)	1816	35.6	707	27.7	1	–
eGFR 45–59 mL/min/1.73 m²	1324	26.0	648	25.4	1.16	1.00 to 1.33
eGFR 30–44 mL/min/1.73 m²	1005	19.7	635	24.9	1.44	1.23 to 1.68
eGFR <30 mL/min/1.73 m²	439	8.6	342	13.4	2.01	1.66 to 2.43
eGFR not recorded	518	10.2	219	8.6	1.23	0.99 to 1.52
Diabetes	1334	26.1	642	25.2	0.85	0.75 to 0.96
Infections¶
Respiratory	497	9.7	2962	11.6	1.31	1.12 to 1.52
Genitourinary	114	2.2	91	3.6	1.64	1.21 to 2.23
Hypothyroidism	508	10.0	318	12.5	1.18	1.00 to 1.39
Anaemia¶	215	4.2	151	5.9	1.35	1.07 to 1.71
Liver disease	127	2.5	82	3.2	1.36	1.00 to 1.85
COPD	968	19.0	512	20.1	1.18	1.03 to 1.36
Depression¶	214	4.2	159	6.2	1.61	1.28 to 2.03
Dementia	117	2.3	77	3.0	1.55	1.12 to 2.16
Cardiovascular drugs**
Diuretics††	3741	73.3	2138	83.8	1.49	1.24 to 1.80
Aldosterone antagonists	747	14.6	864	33.9	2.54	2.23 to 2.90
ACE inhibitors	2906	57.0	1665	65.3	1.68	1.44 to 1.95
ARBs	869	17.0	456	17.9	1.33	1.12 to 1.58
CCBs††	1130	22.1	398	15.6	0.77	0.67 to 0.89
Beta-blockers	1968	38.6	1155	45.3	1.14	1.01 to 1.29
Nitrates	1194	23.4	792	31.0	1.24	1.08 to 1.43
Other drugs**
Antidepressants	740	14.5	484	19.0	1.36	1.18 to 1.57
Opioids	592	11.6	372	14.6	1.24	1.06 to 1.45
Antidiabetics	934	18.3	432	16.9	0.79	0.68 to 0.91

*The OR was adjusted for PCP visits, use of antihypertensive medications (thiazides and related diuretics, loop diuretics, aldosterone antagonists, ACE inhibitors, ARBs, CCBs, and beta-blockers), hypertension, renal failure, ischaemic heart disease, and valvular cardiac disease.
†Healthcare utilisation in the year before the index date was assessed.
‡The reference category was the absence of the corresponding comorbidity.
§Renal function was ascertained by searching for serum creatinine measurements any time before the index date and taking the closest valid serum creatinine value. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation.
¶Anaemia and depression were assessed in the year before the index date and infections in the 3 months before the index date.
**Current use (0–30 days before the index date) was compared with never use as the reference category.
††Other subtypes of diuretics (thiazide and loop diuretics) and subtypes of CCBs (dihydropyridines and non-dihydropyridines (verapamil and diltiazem)) are presented in online supplementary table S2.
ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; BMI, body mass index; CCB, calcium channel blocker; CI, confidence interval; COPD, chronic obstructive pulmonary disease; eGFR, estimated glomerular filtration rate; OR, odds ratio; PCP, primary care physician.