Natriuretic peptides in heart failure: should therapy be guided by BNP levels?

Nat Rev Cardiol. 2010 Jan;7(1):13-20. doi: 10.1038/nrcardio.2009.197. Epub 2009 Nov 24.


Heart failure (HF) is a leading cause of morbidity and mortality worldwide. Testing for natriuretic peptide markers, such as B-type natriuretic peptide (BNP) or N-terminal proBNP (NT-proBNP), has emerged as an important tool for the diagnosis and risk stratification of patients with HF. However, questions remain regarding the potential role for natriuretic peptides to guide therapy in patients with HF. In this Review, we address the underlying assumptions and the existing evidence supporting a natriuretic-peptide-guided approach to the outpatient management of HF.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors
  • Animals
  • Antihypertensive Agents / therapeutic use
  • Diuretics / therapeutic use
  • Heart Failure / blood
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Humans
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Natriuretic Peptide, Brain / blood*
  • Natriuretic Peptide, Brain / drug effects
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Spironolactone / therapeutic use


  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Diuretics
  • Mineralocorticoid Receptor Antagonists
  • Natriuretic Peptide, Brain
  • Spironolactone