Summary

NT-proBNP stands for the amino-terminal portion of pro-B natriuretic peptide type B. It is a hormonally inactive cleavage product of the prohormone BNP (prohormone is a substance from which the active hormone itself is formed by further modifications). BNP is a hormone produced by the heart when it is under stress or damaged. BNP helps the body eliminate excess fluid and salt and therefore lower blood pressure by increasing urine output and relaxing blood vessels. Laboratories are using both NT-proBNP and BNP as biomarkers (indicators) of heart health.

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Overview

BNP, or B-type Natriuretic Peptide, along with its biologically inactive cleavage counterpart NT-proBNP (N-terminal pro-B-type Natriuretic Peptide), are important biomarkers that are measured from blood to diagnose and assess the severity of heart failure. These biomarkers are important in the evaluation of other cardiac diseases. The proBNP molecule (which undergoes cleavage and modification process to form BNP and NT-proBNP) is synthesized and secreted in response to ventricular wall stretch due to increased pressure or volume. This stretching typically occurs when the heart struggles to pump efficiently or when there is a fluid overload in the body.

These peptides, especially BNP, serve not only as diagnostic tools but also as prognostic factors. They help to predict the risk of developing or exacerbating heart failure. Furthermore, elevated levels of BNP and NT-proBNP can foresee the likelihood of hospitalization due to heart failure or other heart-related events. It is important to note that higher levels of these peptides indicate more severe heart failure, whereas lower levels suggest better cardiac function.^[1-3]

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What should you know about this biomarker?

Each laboratory uses different machines and protocols, so the results might vary in terms of the reference ranges or used units of measurement. 

In Macromo blood tests, we use ng/l (nanogram per liter), but you may also find values in pg/ml (picogram per milliliter) on the internet.

An optimal NT-proBNP level depends on factors such as age, sex, and medical history. Generally, a level below 125 ng/l is considered normal for people under 75 years old (for chronic conditions). Acute failure is excluded if the level is < 300 ng/l. 

If the NT-proBNP level is high, further tests may be needed to determine the underlying cause. Treatment depends on the specific condition and may involve lifestyle changes, medication, or surgery in severe cases.^[2-4]

Your blood test results can fall into one of three potential categories:

• If NT-proBNP levels are low, this is not usually a cause for concern. However, if you develop unexpected symptoms or you don't feel well, consult your doctor.
• If NT-proBNP levels are within the reference range, that is a good sign of your heart health. Keep going to regular check-ups to track your health.
• If NT-proBNP levels are elevated, it could be a sign of heart stress. It is recommended to visit and consult your healthcare provider. 

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Genetics

One's genetic background may potentially affect circulating NT-proBNT levels. 

Genetic association analysis was carried out in a group of 4,331 participants from the Long Life Family Study. The research pointed out several allelic variants that could be associated with NT-proBNP levels.^[5] 

In another study (GWAS), scientists identified two SNPs (single nucleotide polymorphisms) that they associate with NT-proBNP levels. However, only one variant has been connected to a higher risk of cardiovascular death.^[6] 

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Recommendations

If your NT-proBNP levels are higher than the normal range, indicating potential heart issues, it would be wise to consider taking the steps listed below to improve your heart health^[2,7]:

• Consume a balanced diet emphasizing fruits, vegetables, whole grains, and lean proteins. It's also advisable to limit sodium intake, which can contribute to fluid retention and exacerbate heart failure.
• Consult your healthcare provider to develop an exercise plan tailored to your condition.^[8] 
• It's important to adhere to any medication regimen prescribed by your doctor to manage your heart condition. Medications like beta-blockers, ACE inhibitors, and diuretics may be prescribed to manage symptoms and reduce the strain on your heart.
• Keeping your blood pressure in check is crucial for heart health.
• If you smoke, it’s crucial to quit, as tobacco use is a significant risk factor for heart disease. Also, it’s advisable to limit alcohol intake as excessive consumption can weaken the heart.
• Regular follow-up appointments with your healthcare provider are essential for monitoring your heart’s function and adjusting treatments as necessary.
• Chronic stress can have adverse effects on the heart. Employ stress-reduction techniques such as deep breathing, meditation, or engaging in hobbies you enjoy.

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The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.