Hormonal
Standard diagnostic biomarkers (BNP/NT-proBNP) are less reliable in obese patients with HF due to lower circulating levels caused by increased clearance by adipose tissue, requiring lower cut-off values for diagnosis.
If you are obese and have heart failure symptoms, standard blood tests for heart failure (BNP/NT-proBNP) might show lower levels than expected, even if you have the condition. Doctors should use lower thresholds to diagnose you. Do not assume a 'normal' result means you don't have heart failure if you have symptoms.
Body mass index is inversely correlated with natriuretic peptides, and obesity can therefore confound the assessment of natriuretic peptides in HF... it has been suggested that lower NT-proBNP cut-off values should be used for ruling out HF in individuals with obesity.
Why this rating
Based on multiple cohorts and analyses cited in the scientific statement.
Source
Heart Failure and Obesity: Translational Approaches and Therapeutic Perspectives. A Scientific Statement of the Heart Failure Association of the ESC
Gianluigi Savarese et al. · European Journal of Heart Failure · 2025
DOI 10.1002/ejhf.3676
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