Study Finds Repeated NT-proBNP a Good General Health Test for Many Folks

A new study, published in the Annals of Internal Medicine, found that a heart stress biomarker called NT-proBNP can help predict cardiovascular disease (CVD) risk and overall mortality in older adults, even those without prior heart issues. The research, based on the ASPREE trial and its extension, analyzed data from over 8,400 healthy people aged 70 and above, primarily from Australia.

The study showed that individuals whose NT-proBNP levels remained below the threshold for three consecutive years had significantly lower risks of CVD and death compared to those who experienced an increase in NT-proBNP levels during this period (an "incident" rise in the biomarker). Specifically, those with a persistent NT-proBNP above the threshold had a 6.7% higher risk of CVD and a 7.5% higher risk of all-cause mortality compared to the control group.

Interestingly, people who had high NT-proBNP readings at the start but then returned to below-threshold levels after three years showed no significant difference in clinical outcomes, indicating that an improvement in NT-proBNP levels could signify a favorable change in CVD and mortality risk states.

The researchers concluded that NT-proBNP could be a valuable general lab test for assessing physiological aging among older adults, regardless of whether they have symptoms. This biomarker integrates various age-related changes in the cardiopulmonary system, such as myocardial wall stress, volume overload, and subclinical dysfunction, similar to how coronary artery calcium reflects vascular aging.

However, the study authors cautioned that NT-proBNP should be viewed more as a marker of subclinical cardiac dysfunction rather than a modifiable therapeutic target. They suggested that future research should determine whether monitoring NT-proBNP trajectories can inform clinical care to reduce CVD and mortality risk in older adults.