Distribution and clinical correlates of elevated NT-proBNP among U.S. adults

NT-proBNP supports rapid triage for acute dyspnoea; however, its population distribution and clinical correlates outside heart failure are incompletely characterised in nationally representative data.

NHANES 1999–2004 adults aged 20–75 years were analysed excluding self-reported heart failure. NT-proBNP elevation was defined as ≥100 pg/mL in men and ≥125 pg/mL in women. Survey weights (surplus-sera) yielded nationally representative estimates. Predictors were evaluated with survey-weighted logistic regression (female sex, age ≥60 years, eGFR <60 mL/min/1.73 m², hypertension, diabetes, obesity, smoking).

Elevated NT-proBNP was present in 15.1% overall, higher in women (19.3%) than men (10.7%). Elevation clustered among chronic kidney disease and obesity strata. In adjusted models, female sex, older age, and reduced eGFR were strongest predictors.

Sex-specific thresholds reveal a substantial burden of elevated NT-proBNP among U.S. adults without heart failure, concentrated in older women and those with impaired kidney function. Targeted testing may enhance early risk stratification and help avert acute decompensation.

Elevated NT-proBNP by Sex