The potential to improve primary prevention in the future by using BNP/N-BNP as an indicator of silent 'pancardiac' target organ damage: BNP/N-BNP could become for the heart what microalbuminuria is for the kidney

Eur Heart J. 2007 Jul;28(14):1678-82. doi: 10.1093/eurheartj/ehm234. Epub 2007 Jun 14.


Brain natriuretic peptide (BNP) or N-terminal pro-BNP (N-BNP) now appears to be the best independent predictor of cardiovascular mortality over and above the conventional ones like blood pressure. This may be because a high BNP/N-BNP is identifying any form of asymptomatic cardiac target organ damage (TOD) [especially silent ischaemia, left ventricular hypertrophy (LVH), left atrial dilatation/atrial fibrillation (LAD/AF) and LV systolic dysfunction (LVSD)]. There are strong hints that BNP/N-BNP will also identify those who are going to develop LVH, LAD/AF, and LVSD in a few years' time. Thus, the prospects are good that BNP/N-BNP could be used to identify 'pancardiac' TOD, even when it is silent and that this information could be 'harnessed' to improve primary prevention. BNP/N-BNP could become to the heart what microalbuminuria is to the kidneys, i.e. an indicator of early, silent TOD.

MeSH terms

  • Biomarkers / blood
  • Death, Sudden, Cardiac / prevention & control*
  • Heart Failure / etiology*
  • Heart Failure / mortality
  • Humans
  • Natriuretic Peptide, Brain / blood*
  • Predictive Value of Tests
  • Primary Prevention / methods
  • Risk Assessment
  • Risk Factors
  • Sensitivity and Specificity


  • Biomarkers
  • Natriuretic Peptide, Brain