N-Terminal Pro–B-Type Natriuretic Peptide in Older Adults: Biomarker and Barometer of Biological Aging

Key Points

• To examine the role of N-terminal pro–B-type natriuretic peptide as a clinical biomarker and barometer of physiological aging beyond isolated cardiovascular conditions in older populations.
• Reviewed clinical, epidemiological, and translational literature evaluating circulating NT-proBNP concentrations in older cohorts.
• Evaluated associations between elevated natriuretic peptide levels, subclinical cardiovascular changes, systemic frailty, and multi-organ biological aging.
• Elevated NT-proBNP concentrations consistently reflect advanced biological aging, subclinical vascular stress, and frailty even in the absence of overt heart failure.
• Higher circulating peptide levels strongly correlate with accelerated functional decline, increased morbidity, and reduced survival across older demographic groups.