Heart failure & cardiomyopathies

Anthropometric adiposity measures and natriuretic peptides in heart failure screening: population-based evidence from the PORTHOS study

Eur J Heart FailPublished Cross-sectional 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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