Heart failure & cardiomyopathies
Anthropometric adiposity measures and natriuretic peptides in heart failure screening: population-based evidence from the PORTHOS study
Authors' conclusion
Obesity is associated with lower N-terminal pro-B-type natriuretic peptide levels despite a higher burden of symptoms and structural abnormalities. Fixed cut-offs do not reliably exclude heart failure in individuals with obesity.
Study context
- Population
- Adults aged 50 years or older, population-based study in Portugal, 2023
- Participants
- 2,498 adults
- Exposure
- Obesity vs lean
- Outcome
- HF symptoms and echocardiographic abnormalities
Methodological detailspopulation-based, NT-proBNP screening, then clinical and echocardiographic assessment if ≥125 pg/mL, self-reported HF, or a 5% random sample <125 pg/mL
- Population-based
- NT-proBNP screening, then clinical and echocardiographic assessment if ≥125 pg/mL, self-reported HF, or a 5% random sample <125 pg/mL
Main finding
As reported in the abstract
Obesity, NT-proBNP <125 pg/mL vs Lean, NT-proBNP >=125 pg/mLOdds ratio (95% CI)
HF symptoms
1.97(1.15–3.38)
Echocardiographic abnormalities
3.63(1.27–10.4)
Observational data: associations, not effects.
Further findings
Obesity prevalence by adiposity measure
- Obesity prevalence, BMI ≥30 kg/m²
- 25%
- Obesity prevalence, waist-to-height ratio ≥0.6
- >70%
BMI and NT-proBNP
- Strong inverse association; ≈50 pg/mL lower NT-proBNP per 5 kg/m² BMI increase
Original publication
Anthropometric adiposity measures and natriuretic peptides in heart failure screening: population-based evidence from the PORTHOS study. Eur J Heart Fail. Published 10 May 2026. doi:10. 1093/ ejhf/ xuag154
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