{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:29:39Z","timestamp":1777674579104,"version":"3.51.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1381,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Ministry of Science, Research and Arts, state of Baden-Wuerttemberg, Germany"},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["RO2602\/14-1"],"award-info":[{"award-number":["RO2602\/14-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["DE2674\/1-1"],"award-info":[{"award-number":["DE2674\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003542","name":"Ministerium f\u00fcr Wissenschaft, Forschung und Kunst Baden-W\u00fcrttemberg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003542","name":"Ministerium f\u00fcr Wissenschaft, Forschung und Kunst Baden-W\u00fcrttemberg","doi-asserted-by":"publisher","award":["RO2602\/14\u20101"],"award-info":[{"award-number":["RO2602\/14\u20101"]}],"id":[{"id":"10.13039\/501100003542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003542","name":"Ministerium f\u00fcr Wissenschaft, Forschung und Kunst Baden-W\u00fcrttemberg","doi-asserted-by":"publisher","award":["DE2674\/1\u20101"],"award-info":[{"award-number":["DE2674\/1\u20101"]}],"id":[{"id":"10.13039\/501100003542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Available upper reference levels (URLs) in older adults for N-terminal pro brain natriuretic peptide (NT-proBNP), an established biomarker for heart failure, are mainly based on small samples. We aimed to identify NT-proBNP URL in a population-based reference sample of individuals aged \u226565 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed established NT-proBNP predictors using quantile regression among 2459 participants of two-independent population-based cohorts located in Germany, the Activity and Function in the Elderly Study (ActiFE, n = 1450) and the Study of Health in Pomerania (SHIP-TREND-0, n = 1009). Based on predictors a reference population of 441 subjects (ActiFE, n = 227; SHIP-TREND-0, n = 214) without history of diabetes, cardiovascular, or pulmonary diseases and with systolic blood pressure (BP) &amp;lt;140 mmHg, diastolic BP \u226560 and \u226490 mmHg, haemoglobin in men \u226514 and \u226418 g\/dL and in women \u226512 and \u226416 g\/dL, GFR \u226560 mL\/min\/1.73 m2, CRP &amp;lt;5 mg\/L, BMI \u226518 and \u226433 kg\/m2, and hs-cTnI &amp;lt;40 ng\/L were built with NT-proBNP median levels and 97.5% quantiles reported stratified by sex and age. In a secondary analysis the URL among 97 SHIP-TREND-0 participants with a left ventricular ejection fraction (LVEF) \u226550 and no diastolic dysfunction were estimated. The median age in the identified reference sample was 70 years, with 41.9% and 40.2% male participants in ActiFE and SHIP-TREND-0, respectively. We observed an age-dependent increment of NT-proBNP levels with higher values in women compared to men. Notably, NT-proBNP levels were &amp;gt;125 ng\/L in 165 participants (37.4%), with NT-proBNP URL (97.5% quantiles) equal to 663, 824, 592, and 697 ng\/L in men, and 343, 463, 2641, 1276 ng\/L in women for ages 65\u201369, 70\u201374, 75\u201379, and 80+ years, respectively. In the secondary analysis with a LVEF \u226550 and no diastolic dysfunction (35 men and 62 women) NT-proBNP levels &amp;gt;125 ng\/L were still observed in 38 (39.2%) participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This reference sample of apparently healthy asymptomatic older adults showed an age-related increment of NT-proBNP levels with URL markedly higher than the European Society of Cardiology recommended cut-off of 125 ng\/L for the diagnosis of heart failure in ambulatory settings. Identifying URL in those \u226580 years remains complex. Our results attempt to provide a frame for the further investigation of age-specific NT-proBNP cut-offs in older adults. Considering the demographic changes, further evaluation of NT-proBNP URL in larger samples of older adults followed by the validation of age-specific cut-off values for the identification of heart failure in those 65 years or older are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13834","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T01:45:27Z","timestamp":1645667127000},"page":"1703-1712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["N-Terminal Pro Brain Natriuretic Peptide Reference Values in Community-Dwelling Older Adults"],"prefix":"10.1093","volume":"9","author":[{"given":"Ulrike","family":"Braisch","sequence":"first","affiliation":[{"name":"Research Unit on Ageing, AGAPLESION Bethesda Clinic , Ulm ,","place":["Germany"]},{"name":"Geriatric Center Ulm\/Alb-Donau , Ulm ,","place":["Germany"]},{"name":"Institute of Epidemiology and 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,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0744-091X","authenticated-orcid":false,"given":"Stephan B.","family":"Felix","sequence":"additional","affiliation":[{"name":"German Centre for Cardiovascular Research, partner site Greifswald , Greifswald ,","place":["Germany"]},{"name":"Department of Internal Medicine B, University Medicine Greifswald , Greifswald ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-7353","authenticated-orcid":false,"given":"Till","family":"Ittermann","sequence":"additional","affiliation":[{"name":"Institute for Community Medicine, University Medicine Greifswald , Greifswald 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