BNP can help diagnose heart conditions, including heart failure, with a high accuracy rate. Both high or low levels may indicate heart issues.
A B-type natriuretic peptide (BNP) blood test measures the levels of the BNP hormone in your blood.
BNP and another heart-related hormone called an atrial natriuretic peptide (ANP) work together to keep your veins and arteries widened or dilated. This allows your blood to easily pass through and prevents clots from forming. BNP and ANP also help your kidneys more easily remove fluid and salt from your body.
When you have congestive heart failure, your heart can’t pump blood properly throughout your body because the walls of your heart chambers, known as the ventricles, become too weak.
This affects pressure and fluid levels in your heart and throughout your body. When this happens, your heart cells produce extra BNP to help maintain the balance of fluids in your body cells and regulate your blood pressure.
A BNP test detects a rise in BNP, which indicates heart failure. Your doctor may recommend this test if you have symptoms of heart failure, such as shortness of breath.
Early diagnosis of heart failure can ensure that you get quick and effective treatment to prevent further complications.
Your doctor may order a BNP blood test if you have symptoms of heart failure, including:
- trouble breathing (dyspnea)
- feeling exhausted or weak for no apparent reason
- rapid weight gain without a change in diet or activity
- inability to concentrate or remain alert
- abnormally high or irregular heart rate
- coughing a lot and producing white or pink phlegm
- nausea or having no appetite
A BNP test can also help rule out heart failure. Other conditions can cause elevated BNP levels, including lung or kidney conditions and obesity.
No special preparation is needed for a BNP test. As it is possible for stress and anxiety to temporarily raise your BNP levels, just do your best to stay calm during the blood draw.
If you faint at the sight of blood or feel weak from fasting, your doctor may recommend that someone come with you in case you’re not able to drive or get yourself home.
A BNP test is done by drawing blood from a vein in your arm using a hypodermic needle. This process is known as venipuncture.
A machine then measures levels of BNP or another heart hormone, called N-terminal-pro BNP (NT-pro-BNP), in the blood sample.
The results from the test are usually ready in 15 to 20 minutes. Results may take up to a week if the blood is sent to a separate lab facility for analysis.
Your results will indicate if your BNP levels are high enough to suspect a diagnosis of heart failure. If you already have a diagnosis of heart failure, the results can help your doctor find out whether heart failure treatments are working.
Generally, BNP levels below 100 picograms per milliliter (pg/mL) are considered normal. But normal BNP levels may vary depending on your age and sex.
Normal BNP range by age and sex
BNP levels increase naturally as you age, and people assigned female at birth typically have slightly higher levels. Underlying conditions can raise your BNP levels, too. Regardless of age or gender, a BNP level of 100 pg/mL or less is considered normal. The higher your level goes above that, the higher your chances are of developing heart failure. Other conditions, like kidney disease, can increase these chances even more.
Your doctor may use BNP tests alongside other diagnostic tests to confirm if you have heart failure or if other conditions are responsible for the increase in your BNP levels.
The chart below shows the normal range, as well as the cutoff levels for a heart failure diagnosis at different ages. These figures use data from a specific type of BNP test called the N-terminal (NT)-pro hormone BNP (NT-proBNP).
| Age Range | BNP Level | What It Means |
| All ages | Under 100 pg/mL | Normal |
| Ages 50 and older | 450 pg/mL and up | Acute heart failure |
| Ages 50 to 75 | 900 pg/mL and up | Acute heart failure |
| Ages 75 and older | 1,800 pg/mL and up | Acute heart failure |
What do high or low BNP levels mean?
In most cases, a high BNP is the greater cause for concern. As your BNP level increases above 100 pg/mL, your chances of developing heart failure increase. These changes already increase with age, so early increases in your BNP level could be cause for alarm.
Generally, anything over 100 pg/mL can indicate some level of heart failure. Heart failure is graded in terms of your ejection fraction or the amount of blood your heart pumps out with every beat. The ejection fraction is a rough estimate of how well your heart is functioning. For example, an
In acute heart failure, your heart function is severely limited — to the point where even regular daily activities like cooking and bathing can be a strain. Depending on your age, a BNP result of 400 pg/mL to 1,800 pg/mL signals acute heart failure.
While a high BNP level is more well-known for being worrisome, some studies suggest that a low BNP can also be a sign of heart trouble. In one study, a small portion of people hospitalized for conditions like heart failure, abnormal heart structure or function, and abnormal hemodynamics (heart rate, blood pressure, and similar readings) had lower than normal BNP levels. Some were so low, in fact, that they couldn’t even be detected on lab tests.
This test has a 98% success rate in ruling out heart failure as a cause of increased BNP levels.
Exercise may cause BNP levels to rise temporarily. Stress can raise your levels of the hormone cortisol, which can also temporarily increase BNP levels.
To confirm a heart failure diagnosis, your doctor may also recommend the following tests:
- full physical examination
- complete blood count (CBC) blood test
- chest X-ray
- echocardiogram
- electrocardiogram (EKG)
- cardiac catheterization
- cardiac MRI
There are no serious risks to having a BNP test performed. Like most tests performed by venipuncture, drawing blood from your vein could cause symptoms like:
- soreness
- bruising
- bleeding
- lightheadedness
These symptoms are usually short-lived, if they develop at all. If you’re concerned about getting lightheaded, you may want to make sure someone drives you home afterward.
If you have symptoms of heart problems like shortness of breath or chest pain, not having a BNP test performed may pose greater risks than the test itself. Early detection of heart failure can help you get treatment sooner and may improve your overall prognosis.
Improving your heart health can help reduce the effects of heart failure and other heart conditions. Consider these heart-healthy steps:
- If you smoke, talk with your doctor about setting up a quit plan.
- Stop consuming alcohol altogether, or drink fewer alcoholic beverages.
- If you are overweight or have obesity, work with your doctor to create a sustainable weight management plan.
- Manage stress through practices such as yoga or meditation.
- Exercise more often than not. Aim for at least 150 minutes of exercise a week.
- Get 7-9 hours of sleep a night.
Depending on the cause of your heart failure and other conditions, your doctor
- a CPAP machine if you have sleep apnea and aren’t breathing well at night
- reducing the use of NSAIDs for pain
- managing conditions like high blood pressure and diabetes
- medications for heart failure, such as ACE inhibitors or beta-blockers
- diuretics to help pass more fluid out of your body
- surgery for coronary bypass or heart valve repair
- inserting a pacemaker
If high BNP levels indicate heart failure, your doctor will tell you the steps to take to prevent complications of this condition.
See your doctor regularly to monitor your BNP levels if needed, and follow any instructions to maintain your best heart health.
Are BNP tests covered by Medicare?
In general, most blood tests ordered by your doctor as medically necessary to diagnose or treat a condition are usually covered by Medicare. In the case of BNP testing, this testing is covered, but with some restrictions. The test may not be covered as a stand-alone test or as a tool for monitoring congestive heart failure. Additionally, Medicare will usually only cover up to four BNP tests each year.
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Can a complete blood count (CBC) detect congestive heart failure?
A CBC blood test
What are the four signs your heart is quietly failing?
The four signs of heart failure are unexplained breathlessness, fatigue, fainting, and swelling in the ankles or legs.
However, these symptoms can be caused by other things, and some people with heart failure can experience other symptoms, such as a cough, for example.
That said, getting medical attention is crucial to rule out heart failure, as it is life threatening.
What is the blood marker for a heart attack?
When you have a heart attack, a protein called troponin is released into your blood. This protein is normally found in the heart muscle, so finding it in a lab result can help diagnose a heart attack.
BNP is a blood test that is used to help diagnose conditions like heart failure. This test is commonly done in the emergency department if you show up with symptoms like shortness of breath.
High BNP levels are usually associated with an increased risk of developing heart failure, but low BNP levels can also signal some heart problems.
If your doctor orders a BNP test for you, they will interpret your results based on your individual age, gender, and other health conditions.
