Aim: Salbutamol, a beta-2 agonist inhaler, is commonly prescribed in primary health care for adults with dyspnoea, wheeze and cough thought to be due to respiratory causes, but the diagnosis may be uncertain. Salbutamol prescription may indicate an increased risk of hospital admission for new heart failure (HF) Method: From a cohort of ∼5 million primary care patients, HF cases were defined as any patient with a first hospital admission for HF between 2008 and 2014. Control patients with no diagnosis of HF were matched 1: 4-5 based on age, gender and timing of the primary care encounter. The index date was the date of hospital admission for HF cases and their matched controls. The National Pharmaceutical Collection identified all medications prescribed ≤90 days, and new medications prescribed ≤30 days prior to the index date. Odds Ratios (OR) for risk of HF were calculated for salbutamol prescription for all HF cases compared to controls, and stratified by comorbidities. Logistic regression was used to calculate ORs adjusted for comorbidities. Results:Tabled 1HF CasesControlsORAdjusted ORn = 62,164n = 276,223(95% CI)*P<0.001 for all.(95% CI)*P<0.001 for all.Salbutamol dispensed ≤90 days9,538(15.3%)13,160(4.8%)3.6(3.5-3.7)2.5(2.4-2.6)Risk-associated with salbutamol use over prior 90 days and comorbidityAtrial fibrillation1,079(1.7%)461(0.2%)10.6(9.5-11.8)4.0(3.5-4.5)Coronary artery disease915(1.5%)460(0.2%)9.0(8.0-10.0)2.9(2.6-3.3)Chronic kidney disease970(1.6%)499(0.2%)8.8(7.9-9.8)2.8(2.5-3.2)New prescription for salbutamol ≤30 days1,393(2.2%)931(0.3%)6.8(6.2-7.4)6.0(5.5-6.6)* P < 0.001 for all. Open table in a new tab Conclusion: Salbutamol prescription in primary care was associated with an increased risk of hospital admission for HF, particularly following a new prescription.