Relationship between obesity and B-type natriuretic peptide levels

Arch Intern Med. 2004 Nov 8;164(20):2247-52. doi: 10.1001/archinte.164.20.2247.


Background: The relationships among B-type natriuretic peptide (BNP) levels, body mass index (BMI), and congestive heart failure (CHF) as an emergency diagnosis are unknown.

Methods: Of 1586 participants in the Breathing Not Properly Multinational Study who had acute dyspnea, 1369 (86.3%) had BNP values and self-reported height and weight. Two independent cardiologists masked to the BNP results adjudicated the final diagnosis.

Results: Congestive heart failure was found in 46% of participants. Individuals with higher BMIs were younger and had more frequent edema on examination but were equally as likely to have CHF vs noncardiac sources of dyspnea. A nearly 3-fold difference was seen in mean +/- SD BNP values at the low and high extremes of the BMI groupings (516.7 +/- 505.9 vs 176.3 +/- 270.5 pg/mL, respectively; P< .001). The correlations between BMI and log BNP among those with and without CHF were r = -0.34 and r = -0.21, respectively (P< .001 for both). Multivariate analysis for the outcome of log BNP among a small subset with CHF (n = 62) found that Framingham score (P = .002), estimated glomerular filtration rate (P = .007), female sex (P = .03), New York Heart Association functional class (P = .09), and third heart sound (P = .08) were independent predictors. However, BMI was not found to be independently related to log BNP (P = .59).

Conclusions: In patients with and without CHF, BNP levels are inversely related to BMI. When considering demographics, severity of disease, and renal function, BMI is not independently related to BNP levels in a small subgroup when detailed information about CHF severity is known.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Biomarkers / analysis
  • Body Mass Index
  • Cohort Studies
  • Emergency Service, Hospital
  • Female
  • Heart Failure / diagnosis*
  • Heart Failure / epidemiology*
  • Heart Failure / therapy
  • Humans
  • Incidence
  • Linear Models
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / analysis*
  • Obesity / diagnosis*
  • Obesity / epidemiology*
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Distribution
  • Survival Analysis


  • Biomarkers
  • Natriuretic Peptide, Brain