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Cardiovascular

NT-proBNP in men: limits per age and risk factors for heart failure

According to the NHG, when the wall of the heart's chambers comes under tension from too much pressure or too much fluid, the heart muscle cells make extra BNP, with NT-proBNP as the inactive split-off product. According to the NVKC, the hormone pro-BNP, from which both arise, supports the pumping function by lowering blood pressure and making the body pass more salt and water in the urine.

A high NT-proBNP can fit heart failure, and according to the NVKC the higher the level, the more severe the heart failure. Only a blood test shows how much NT-proBNP is in the blood.

Unilabs uses 0 to 86 ng/l for men aged 18 to 45 and 0 to 486 ng/l for men aged 75 to 150.

Doctor's Assessment Included

NT-proBNP is the inactive piece of a hormone that the heart's chambers make extra of when their wall is under tension. According to the NVKC, a strongly raised level points to heart failure.

  • With suspected non-acute heart failure, the NHG uses an NT-proBNP cut-off of 125 pg/ml, which according to the NHG corresponds to 15 pmol/l, even when the laboratory uses other reference values.
  • According to the NHG, besides heart failure, chronic kidney damage, atrial fibrillation, older age and a severe infection can also raise NT-proBNP.
  • According to the NHG, in atrial fibrillation an NT-proBNP below the cut-off gives too little certainty to rule out heart failure.

When is this value abnormal?

Decision limits per result, in pmol/l
Result Value (pmol/l)
Normal < 15
Elevated ≥ 15

This is a cut-off value, not a reference value: the NHG guideline on heart failure prescribes this limit, even if the laboratory states other reference values. It applies to symptoms that developed gradually (not acutely). Note: in atrial fibrillation, a value below the cut-off does not rule out heart failure. NT-proBNP can be lowered by overweight and by heart-failure medication, and raised by kidney damage, atrial fibrillation, older age and severe infection.

Source: Nederlands Huisartsen Genootschap Reference population: Adults with suspected heart failure (NHG guideline on heart failure)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

NT-proBNP: what Dutch laboratories use

Reference ranges by group, in pmol/l
Star-shl · Everyone · up to 49 years · heart failure unlikely 0–15 pmol/l
0 15
Star-shl · Everyone · up to 49 years · heart failure possible 15–50 pmol/l
15 50
Star-shl · Everyone · up to 49 years · a limit, not a range · possible acute heart failure > 50 pmol/l
50
Star-shl · Everyone · 50–75 years · heart failure unlikely 0–15 pmol/l
0 15
Star-shl · Everyone · 50–75 years · heart failure possible 15–100 pmol/l
15 100
Star-shl · Everyone · 50–75 years · a limit, not a range · possible acute heart failure > 100 pmol/l
100
Star-shl · Everyone · 76 years and older · heart failure unlikely 0–15 pmol/l
0 15
Star-shl · Everyone · 76 years and older · heart failure possible 15–200 pmol/l
15 200
Star-shl · Everyone · 76 years and older · a limit, not a range · possible acute heart failure > 200 pmol/l
200
Unilabs · Male · 18–45 years 0–86 ng/l
Unilabs · Male · 45–55 years 0–121 ng/l
Unilabs · Male · 55–65 years 0–210 ng/l
Unilabs · Male · 65–75 years 0–376 ng/l
Unilabs · Male · 75–150 years 0–486 ng/l
Certe · Everyone · 18 years and older · a limit, not a range < 125 ng/L
Diagnostiek voor U · Everyone · a limit, not a range < 125 pg/mL
0 220 pmol/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

NT-proBNP: what this test measures

An NT-proBNP test measures the amount of NT-proBNP in the blood, at Unilabs in ng/l, with 0 to 121 ng/l for men from 45 to 55, 0 to 210 ng/l from 55 to 65 and 0 to 376 ng/l from 65 to 75. According to the NVKC, NT-proBNP rises with age, which is why laboratories also use limits per age.

NT-proBNP: why this value matters

According to the NHG, NT-proBNP is used to rule out heart failure or make it more likely, and according to the NHG people older than 55 have about a 30% chance of getting heart failure during their life. According to the NHG, of the new patients with heart failure that GPs registered in 2018, most of the men were 75 to 84 years old.

NT-proBNP: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

NT-proBNP: when is testing worthwhile?

According to the NHG, an NT-proBNP test belongs with suspected heart failure, and the NHG names smoking, high blood pressure, type 2 diabetes, heavy alcohol use, high cholesterol, obesity and chronic kidney damage as risk factors for cardiovascular disease.

NT-proBNP: symptoms of a high or low value

Low Levels

Obesity and medicines such as beta blockers, ACE inhibitors and diuretics can lead to a lower NT-proBNP, according to the NHG, and in men the levels are lower than in women on average.

High Levels

Left ventricular hypertrophy, an increased wall thickness of the left ventricle, and atrial fibrillation or another rhythm disorder can give a raised NT-proBNP besides heart failure, according to the NHG. According to Thuisarts, heart failure itself can come from damage to the heart muscle, for example from a heart attack, or from years of high blood pressure without treatment, among other causes.

NT-proBNP: causes of a low or high value

What lowers the value

  • Obesity

    Obesity can lead to a lower NT-proBNP.

  • Heart medicines

    Treatment with diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers or aldosterone antagonists can lead to a lower NT-proBNP.

What raises the value

  • Heart failure

    Strongly raised levels point to heart failure: the higher the level, the more severe the heart failure. A slightly raised level can also occur in people without heart failure.

  • Chronic kidney damage

    Chronic kidney damage can lead to a raised NT-proBNP, also without heart failure.

  • Atrial fibrillation or another rhythm disorder

    Atrial fibrillation or another rhythm disorder can lead to a raised NT-proBNP; in atrial fibrillation the test is not recommended for proving or ruling out heart failure.

  • Older age

    Older age can lead to a raised NT-proBNP.

  • Severe infection

    A severe infection can lead to a raised NT-proBNP.

NT-proBNP: lifestyle and this value

An abnormal NT-proBNP is a reason to talk to your GP. According to the NHG, with an NT-proBNP above 2000 pg/ml heart failure is almost certain in someone with symptoms that fit heart failure, and even then, according to the NHG, a referral is needed to establish the type and to look into the possible causes.

NT-proBNP: frequently asked questions

Why does the upper limit rise with age?

The upper limit of NT-proBNP rises with age because, according to the NVKC, the amount of NT-proBNP increases with age, which is why laboratories use age-dependent limits, according to the NVKC. At Unilabs the upper limit for men goes from 86 ng/l at 18 to 45 to 486 ng/l at 75 to 150.

NT-proBNP: sources

  1. NHG-Standaard Hartfalen (M51). Gepubliceerd mei 2021, laatste aanpassing februari 2026. "Bepaal het B-type natriuretisch peptide (BNP) of het N-terminaal proBNP (NT-proBNP) en gebruik daarbij de volgende afkapwaarden, ook als het laboratorium andere referentiewaarden aanhoudt: ... NT-proBNP 125 pg/ml (komt overeen met 15 pmol/l)." Geraadpleegd 14 juli 2026. (retrieved 2026) richtlijnen.nhg.org
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. NHG-Standaard Hartfalen (M51), mei 2021, laatste aanpassing februari 2026, richtlijnen.nhg.org, geraadpleegd 2026-10-14 (retrieved 2026) richtlijnen.nhg.org
  7. NVKC, Alles over testen: BNP of NTproBNP, allesovertesten.nl, geraadpleegd 2026-10-14 (retrieved 2026) allesovertesten.nl

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