Takeaway
- Hypotension occurred frequently in patients with incident heart failure (HF) and the risk was higher in younger women than men.
- Patients with greater health care utilisation, specific comorbidities, past hypotensive episodes, and those who received anti-hypertensive medications were at increased risk of developing hypotension.
Why this matters
- Findings may help identify patients most likely to benefit from close blood pressure monitoring.
Study design
- 18,677 patients with HF and 5102 age-, sex- and index date-matched control patients were included using the data from the Health Improvement Network primary care database (THIN).
- Primary outcome: incidence of hypotension.
- Secondary outcomes: risk factors for the development of hypotension and multiple vs single hypotensive episodes.
- Funding: Bayer AG.
Key results
- During a median follow-up of 3.12 (interquartile range, 0.96-6.86) years, 2565 patients (13.7%) developed ≥1 hypotension episode.
- The incidence rate of overall hypotension was 3.17 (95% CI, 3.05-3.30) cases per 100 patient-years in patients with HF and was higher in women aged 18-39 years (17.72 [95% CI, 9.69-29.73] cases per 100 patient-years).
- The risk factors for the development of hypotension were:
- health care utilisation (≥10 primary care physician visits vs none; OR, 2.29; 95% CI, 1.34-3.90),
- previous hypotensive episodes (OR, 2.32; 95% CI, 1.84-2.92),
- renal failure, and
- use of aldosterone antagonists (OR, 2.54;95% CI, 2.23-2.90), angiotensin-converting enzyme inhibitors (OR, 1.68; 95% CI, 1.44-1.95) and angiotensin receptor blockers (OR, 1.33; 95% CI, 1.12-1.58).
- Risk factors for hypotension overlapped with those for multiple vs single hypotensive episodes.
Limitations
- Retrospective design
- Risk of bias.
References
References
