NT-proBNP Underestimates Heart Failure Risk
The same N-terminal pro-B-type natriuretic peptides (NT-proBNP) concentration could mean drastically different absolute risks of heart failure (HF) for different demographics, according to a cohort study suggesting the importance of sex and race in interpreting risk for people free of HF at baseline.

In the longitudinal Atherosclerosis Risk in Communities (ARIC) cohort, Black men, compared with white women, had up to a seven-fold higher risk of incident HF or death in midlife than predicted based on the same guideline-recommended threshold for NT-proBNP. In the study, among ARIC participants in midlife and late life, Black men consistently had the lowest NT-proBNP concentrations (30 pg/mL and 74 pg/mL, respectively), whereas white women had the highest concentrations (70 pg/mL and 154 pg/mL, respectively).

Sex and race differences in NT-proBNP concentration persisted after accounting for known physiologic determinants. Black men are known to be more prone to heart failure even after accounting for established cardiovascular risk factors.

Source: https://jamanetwork.com/journals/jamacardiology/article-abstract/2791260