Factors strongly associated with in-hospital hypotension included randomization to nesiritide ( odds ratio , 1.98 ; 95 % confidence interval [ CI ] , 1.76-2 .23 ; P < 0.001 ) , chronic metolazone therapy ( odds ratio , 1.74 ; 95 % CI , 1.17-2 .60 ; P < 0.001 ) , and baseline orthopnea ( odds ratio , 1.31 ; 95 % CI , 1.13-1 .52 ; P = 0.001 ) or S3 gallop ( odds ratio , 1.21 ; 95 % CI , 1.06-1 .40 ; P = 0.006 ) .