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Published on: June 10, 2025
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NT-proBNP in the very old population: reference values and heart failure specificity from the AugUR-study
Maria A Heinrich1, Klaus J Stark2, Martina E Zimmermann2
1Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
Summary
NT-proBNP levels increase with age, with over 50% of healthy elderly individuals exceeding the heart failure diagnostic threshold. This highlights the need for age-specific reference values in older populations.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Biomarker Research
Background:
- Elevated NT-proBNP is a known heart failure marker.
- Older individuals often have higher NT-proBNP, even without heart disease.
- Established reference values for healthy elderly populations are lacking.
Purpose of the Study:
- Determine NT-proBNP reference values in healthy elderly and very old individuals.
- Assess the proportion of healthy elderly exceeding the heart failure rule-out threshold (≥125 pg/mL).
Main Methods:
- Analysis of cross-sectional data from the population-based AugUR study (≥70 years).
- NT-proBNP levels measured in serum.
- Cardiac morphology and function assessed via echocardiography.
Main Results:
- 2304 subjects (70-95 years) analyzed; median NT-proBNP increased with age.
- 68% of all subjects had NT-proBNP ≥125 pg/mL.
- In cardiovascularly healthy subgroups, 50-70% had NT-proBNP ≥125 pg/mL, with 97.5% quantiles significantly higher than the threshold.
Conclusions:
- NT-proBNP levels progressively increase in the very old.
- Over 50% of healthy individuals aged 70+ exceed the 125 pg/mL cut-off.
- This finding may lead to unnecessary diagnostic procedures and referrals in the elderly.
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