Guideline for the Use of Natriuretic Peptides in the Early Diagnosis and Management of Heart Failure in Primary Care

Heart failure (HF) is a complex clinical condition associated with significant morbidity and mortality. Early diagnosis and effective management at the primary care level are essential for improving patient outcomes and reducing the burden on the healthcare systems. The Eurasian Society of HF and the Turkish Association of Family Medicine developed a guideline that underscores the critical role of natriuretic peptides (NPs) in the early detection, diagnosis, and management of HF. NPs, particularly the N-terminal pro-B-type NP, are a reliable biomarker for identifying HF, guiding treatment decisions, and monitoring disease progression. This guideline emphasizes the importance of measuring the levels of these peptides in primary care so as to detect individuals at risk, confirm the diagnosis of HF in symptomatic patients, and evaluate the treatment response. The recommended thresholds for NP levels account for variations arising from factors such as age, gender, and the presence of other health conditions. B-type natriuretic peptides (BNP) levels ≥ 35 pg/ml or N-terminus-proBNP levels ≥ 125 pg/ml are used to confirm the likelihood of HF in symptomatic patients, enabling timely diagnosis and appropriate intervention. Incorporating NP testing into routine clinical practice enables timely referrals and ensures appropriate management at all stages of HF. Beyond diagnosis, the measurement of NPs provides valuable information about treatment effectiveness and prognosis, allowing clinicians to individualize the treatment. By integrating NP testing into primary care, healthcare providers can facilitate early detection, optimize treatment strategies, and improve the quality of life for patients with or at risk of HF. Thus, this guideline highlights the essential role of primary care physicians in addressing the growing challenges of HF through the effective and evidence-based use of NPs.