NT-proBNP

Other names: brain natriuretic peptide, NT-proB-type natriuretic peptide test, B-type natriuretic peptide

check icon Optimal Result: 0 - 210 pg/mL.

NT-proBNP Test: What It Means and Why It Matters

What is NT-proBNP?
N-terminal pro B-type natriuretic peptide (NT-proBNP) is a protein released by the heart when it is under stress or strain. Normally, only small amounts are present in the blood. When the heart has to work harder—such as in heart failure—NT-proBNP levels rise, making it a key biomarker for diagnosing and monitoring heart health.


Why is the NT-proBNP Test Done?

Your healthcare provider may order an NT-proBNP test if you have symptoms that could be related to heart failure, such as:

  • Shortness of breath or difficulty breathing

  • Swelling in the legs, ankles, or abdomen (edema)

  • Fatigue, weakness, or reduced ability to exercise

  • Cough or wheezing that worsens when lying down

  • Dizziness, fainting, or heart palpitations

Because these symptoms can also occur with lung, kidney, or liver conditions, NT-proBNP helps your doctor determine whether your heart is the main cause.

If you already have a diagnosis of heart failure, NT-proBNP may be used to:

  • Assess the severity of the condition

  • Monitor whether treatments are working

  • Help guide adjustments in therapy

  • Provide prognostic information (how the disease may progress)


BNP vs. NT-proBNP: What’s the Difference?

Both BNP and NT-proBNP come from the same source—a larger precursor protein made in the heart.

  • BNP: The active hormone that helps the body get rid of extra salt and water, reducing strain on the heart.

  • NT-proBNP: An inactive fragment that stays in the blood longer, making it more stable and easier to measure accurately.

Your provider will usually order one test, not both, depending on the laboratory and equipment available.


What Do NT-proBNP Results Mean?

Normal ranges may vary based on age and kidney function, but general cutoffs are:

  • Under 50 years:

    • Less than 300 pg/mL helps rule out heart failure

    • Greater than 450 pg/mL may indicate heart failure

  • Ages 50–75 years:

    • Less than 300 pg/mL helps rule out heart failure

    • Greater than 900 pg/mL may indicate heart failure

  • Over 75 years:

    • Less than 300 pg/mL helps rule out heart failure

    • Greater than 1,800 pg/mL may indicate heart failure

Other factors can affect results:

  • Kidney disease may increase NT-proBNP levels

  • Obesity may lower levels

  • Heart medications (ACE inhibitors, beta blockers, diuretics) can reduce levels

Always discuss your exact numbers with your healthcare provider, since “normal” depends on your age, health history, and other test results.


What Happens After the Test?

If NT-proBNP levels suggest heart failure, your doctor may order additional tests to confirm and assess heart function, such as:

  • Electrocardiogram (ECG/EKG) – checks heart rhythm

  • Echocardiogram – uses ultrasound to see how well the heart is pumping

  • Chest X-ray – shows fluid in the lungs or an enlarged heart

  • Stress test – evaluates how your heart responds to physical exertion


Beyond Heart Failure: Other Uses of NT-proBNP

Although most commonly linked with heart failure, NT-proBNP can also be elevated in other heart-related and lung conditions, including:

  • Acute coronary syndrome (ACS)

  • Pulmonary embolism (blood clot in the lungs)

  • Chronic kidney disease

In some studies, NT-proBNP has even been shown to predict risk of death in patients with heart attacks—sometimes more effectively than troponin tests.


Key Takeaways

  • NT-proBNP is a powerful and reliable blood test for diagnosing, monitoring, and managing heart failure.

  • High levels often mean the heart is struggling to pump effectively.

  • Normal or low levels can help rule out heart failure as the cause of symptoms.

  • Results must always be interpreted in the context of age, kidney function, medications, and overall health.


If you are experiencing sudden shortness of breath, chest pain, fainting, or severe swelling, seek emergency medical care immediately. Heart failure is a serious, life-threatening condition that requires prompt treatment.

What does it mean if your NT-proBNP result is too high?

What Do Elevated NT-proBNP Levels Mean?

An elevated NT-proBNP (N-terminal pro B-type natriuretic peptide) level usually signals that the heart is under stress and may not be pumping blood as effectively as it should. The test is most often used to help diagnose or monitor heart failure, but high levels can also occur in other conditions. Doctors interpret NT-proBNP results together with symptoms, medical history, and other tests to get a complete picture of heart health.

Common causes of elevated NT-proBNP include:

  • Heart failure – the most common reason, often correlating with the severity of the condition.

  • Other heart problems – such as a recent heart attack (myocardial infarction), valve disease, or cardiomyopathy.

  • Lung diseases – including pulmonary hypertension or pulmonary embolism, which can strain the right side of the heart.

  • Kidney dysfunction – since the kidneys help clear NT-proBNP, reduced kidney function can cause higher levels.

  • Atrial fibrillation – an irregular heartbeat that often leads to elevated NT-proBNP.

While high levels raise concern for heart failure, they don’t confirm it on their own. Age, kidney function, obesity, and medications can all influence results. Your healthcare provider will use NT-proBNP alongside other tests—like an echocardiogram or ECG—to make a clear diagnosis and guide treatment.

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