Natriuretic Peptide Tests (BNP, NT-proBNP) Understand the Test & Your Results (2024)

Accordion Title

  • What are natriuretic peptide tests (BNP, NT-proBNP)?

    Natriuretic peptides are substances made by the heart. Two main types of these substances are brain natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP). Normally, only small levels of BNP and NT-proBNP are found in the bloodstream. High levels can mean your heart isn't pumping as much blood as your body needs. When this happens, it's known as heart failure , sometimes called congestive heart failure.

    Natriuretic peptide tests measure the levels of BNP or NT-proBNP in your blood. Your health care provider may order a BNP test or an NT-proBNP test, but not both. They are both useful in diagnosing heart failure, but rely on different types of measurements. The choice will depend on the equipment available in your provider's recommended laboratory.

    Other names: brain natriuretic peptide, NT-proB-type natriuretic peptide test, B-type natriuretic peptide

  • What are they used for?

    A BNP test or an NT-proBNP test is most often used to diagnose or rule out heart failure. If you've already been diagnosed with heart failure, the test may be used to:

    • Find out the severity of the condition
    • Plan treatment
    • Find out if treatment is working

    The test may also be used to find out whether or not your symptoms are due to heart failure.

  • Why do I need a natriuretic peptide test?

    You may need a BNP test or an NT-proBNP test if you have symptoms of heart failure. These include:

    • Difficulty breathing
    • Coughing or wheezing
    • Fatigue
    • Swelling in abdomen, legs, and/or feet
    • Loss of appetite or nausea

    If you are being treated for heart failure, your health care provider may order one of these tests to see how well your treatment is working.

  • What happens during a natriuretic peptide test?

    For a BNP test or an NT-proBNP test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

  • Will I need to do anything to prepare for the test?

    You don't need any special preparations for a BNP test or an NT-proBNP test.

  • Are there any risks to the test?

    There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

  • What do the results mean?

    If your BNP or NT-proBNP levels were higher than normal, it probably means you have heart failure. Usually, the higher the level, the more serious your condition is.

    If your BNP or NT-proBNP results were normal, it probably means your symptoms are not being caused by heart failure. Your provider may order more tests to help make a diagnosis.

    If you have questions about your results, talk to your health care provider.

    Learn more about laboratory tests, reference ranges, and understanding results .

  • Is there anything else I need to know about a natriuretic peptide test?

    Your health care provider may order one or more of the following tests in addition to or after you've had a BNP or NT-proBNP test:

    • Electrocardiogram , which looks at heart's electrical activity
    • Stress test , which shows how well your heart handles physical activity
    • Chest x-ray to see if your heart is larger than normal or if you have fluid in your lungs

    You may also get one or more of the following blood tests:

    • ANP test. ANP stands for atrial natriuretic peptide. ANP is similar to BNP but it is made in a different part of the heart.
    • Metabolic panelto check for kidney disease, which has similar symptoms to heart failure
    • Complete blood count to check for anemia or other blood disorders
  • References
    1. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2019. Diagnosing Heart Failure; [cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.heart.org/en/health-topics/heart-failure/diagnosing-heart-failure
    2. Bay M, Kirk V, Parner J, Hassager C, Neilsen H, Krogsgaard, K, Trawinski J, Boesgaard S, Aldershvile, J. NT-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function. Heart. [Internet]. 2003 Feb [cited 2019 Jul 24]; 89(2):150–154. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767525
    3. Doust J, Lehman R, Glasziou P. The Role of BNP Testing in Heart Failure. Am Fam Physician [Internet]. 2006 Dec 1 [cited 2019 Jul 24]; 74(11):1893–1900. Available from: https://www.aafp.org/afp/2006/1201/p1893.html
    4. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2019. NT-proB-type Natriuretic Peptide (BNP); [cited 2019 Jul 24]; [about 3 screens]. Available from: https://my.clevelandclinic.org/health/diagnostics/16814-nt-prob-type-natriuretic-peptide-bnp
    5. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. BNP and NT-proBNP; [updated 2019 Jul 12; cited 2019 Jul 24]; [about 2 screens]. Available from: https://labtestsonline.org/tests/bnp-and-nt-probnp
    6. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Congestive Heart Failure; [updated 2017 Oct 10; cited 2019 Jul 31]; [about 2 screens]. Available from: https://labtestsonline.org/conditions/congestive-heart-failure
    7. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Blood tests for heart disease; 2019 Jan 9 [cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357
    8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
    9. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Brain natriuretic peptide test: Overview; [updated 2019 Jul 24; cited 2019 Jul 24]; [about 2 screens]. Available from: https://ufhealth.org/brain-natriuretic-peptide-test
    10. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Exercise stress test: Overview; [updated 2019 Jul 31; cited 2019 Jul 31]; [about 2 screens]. Available from: https://ufhealth.org/exercise-stress-test
    11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: BNP (Blood); [cited 2019 Jul 24]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=bnp_blood
    12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Brain Natriuretic Peptide (BNP) Test: Results; [updated 2018 Jul 22; cited 2019 Jul 24]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/brain-natriuretic-peptide-bnp/ux1072.html#ux1079
    13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Brain Natriuretic Peptide (BNP) Test: Test Overview; [updated 2018 Jul 22; cited 2019 Jul 24]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/brain-natriuretic-peptide-bnp/ux1072.html
    14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Brain Natriuretic Peptide (BNP) Test: Why It Is Done; [updated 2018 Jul 22; cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/brain-natriuretic-peptide-bnp/ux1072.html#ux1074
Natriuretic Peptide Tests (BNP, NT-proBNP) Understand the Test & Your Results (2024)

FAQs

Natriuretic Peptide Tests (BNP, NT-proBNP) Understand the Test & Your Results? ›

A BNP test or NT-proBNP test detects heart failure by measuring the amount of BNP or its prohormone NT-proBNP in the bloodstream, respectively. High levels of BNP or NT-proBNP are a sign that the heart has to work too hard to pump blood.

What BNP level is worrisome? ›

BNP levels go up when the heart cannot pump the way it should. A result greater than 100 pg/mL is abnormal. The higher the number, the more likely heart failure is present and the more severe it is.

What level of NT-proBNP indicates heart failure? ›

The Universal definition of heart failure states that NT-proBNP (N-terminal pro-B-type natriuretic peptide) ≥125 pg/mL is corroborating evidence of heart failure in the acute setting, but this single threshold may not be optimal for screening in the general population.

What does it mean when your proBNP is high? ›

Higher than normal levels of BNP or NT-proBNP mean that you could have heart failure. Your provider will probably order other heart health tests to help make a final diagnosis.

How do I get my BNP levels down? ›

How to Lower BNP Levels Naturally. Follow your doctor's advice, but you can take some steps at home in addition to treatment to help with your heart failure and get your BNP levels down. For instance: One study found that people who cut down on the amount of salt in their diet lowered their BNP.

What is the life expectancy of someone with high BNP? ›

In this study, we found that extremely high BNP value (>5000 ng/L) had a serious influence on both the short-term and long-term mortality rate. The mortality rate of 13 cases in 3 months was 53.8% (7/13), in 2 years was 69.2% (9/13) and in 5 years all patients died (13/13).

What is BNP level by age? ›

What Are Normal and High BNP Levels?
ConditionAgesBNP Level (pg/mL)
NormalAnyLess than 300
Possible heart failureUnder the age of 50More than 450
Possible heart failureBetween ages 50 to 75More than 900
Possible heart failureOver the age of 75More than 1,800

What are the four stages of congestive heart failure? ›

Heart failure can progress, so researchers have identified four stages of the disease — A, B, C and D. Health care professionals also classify heart failure when it has progressed to stages C and D. This classification measures a patient's overall heart function and severity of symptoms.

How do I lower my NT-proBNP? ›

Engage in aerobic exercises like brisk walking, jogging, cycling, or swimming. These activities improve cardiovascular health, enhance blood circulation, and reduce NT-proBNP levels.

What else can cause high BNP? ›

Conditions associated with elevated BNP other than CHF are as follows: Acute renal failure and chronic renal failure. Hypertension (HTN) Pulmonary diseases such as pulmonary hypertension, severe chronic obstructive pulmonary disease (COPD), pneumonia, pulmonary embolism, adult respiratory distress syndrome (ARDS)

How long can I live with heart failure? ›

Research estimates that more than half of all people with congestive heart failure will survive for 5 years after diagnosis. About 35% will survive for 10 years. However, in some cases, a person can extend their life expectancy through lifestyle changes, medications, and surgery.

Can heart failure be reversed? ›

There's no cure for CHF. In some cases, though, significant lifestyle changes and medications can slow or reverse the course of CHF and improve cardiac function. If valve disease is the main cause of heart failure, successful valve replacement or repair may be enough to restore the heart's healthy pumping ability.

Can proBNP go down? ›

Both BNP and NT-proBNP are released in response to pressure changes inside the heart, which can be related to cardiac problems, including heart failure. Levels go up when heart failure develops or gets worse, and down when conditions are stable.

Can losing weight lower BNP? ›

Weight loss interventions can reverse this “natriuretic handicap”22,23,24,25,26,27, although some studies also reported decreased BNP and NT-proBNP concentrations after weight loss29,30,31.

What is a concerning level of BNP? ›

BNP levels over 100 pg/mL may be a sign of heart failure. For NT-proBNP, normal levels are less than 125 pg/mL for people under 75 years old and less than 450 pg/mL for people over age 75. NT-proBNP levels over 900 pg/mL may be a sign of heart failure. Every person has their own range of BNP or NT-proBNP level range.

What is the treatment for high BNP levels? ›

Treatment with angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, spironolactone, and diuretics reduces BNP levels, suggesting that BNP testing may have a role in monitoring patients with heart failure.

What does a BNP of 400 mean? ›

A BNP greater than 400 pg/mL indicates that heart failure is likely. Other conditions that are associated with a high BNP other than congestive heart failure include: Acute renal failure and chronic renal failure. Patients on dialysis.

What is the cut-off for BNP for heart failure? ›

BNP levels below 100 pg/mL and those above 500 pg/mL have, respectively, a 90% negative predictive value (NPV) and positive predictive value (PPV) for the diagnosis of congestive heart failure (CHF) in patients presenting with acute dyspnea.

Does high BNP mean fluid overload? ›

Brain natriuretic peptide (BNP) is secreted from the heart in response to volume overload, and may be a marker of overhydration in hemodialysis patients.

What is the highest BNP can be? ›

Normal BNP range by age and sex
Age RangeBNP LevelWhat It Means
All agesUnder 100 pg/mLNormal
Ages 50 and older450 pg/mL and upAcute heart failure
Ages 50 to 75900 pg/mL and upAcute heart failure
Ages 75 and older1,800 pg/mL and upAcute heart failure

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