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

Abstract Background 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. Methods 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). Results 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. Conclusions 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 Predictors of Elevated NT-proBNP