NT-proBNP in women: the limits per age and what heart failure means

Q: Do women have a higher NT-proBNP than men?

Yes, according to the NHG men have lower NT-proBNP levels than women on average. Unilabs uses an upper limit of 738 ng/l for women aged 75 to 150 and 486 ng/l for men aged 75 to 150.

According to the NVKC, the hormone pro-BNP, which is cut into BNP and NT-proBNP, helps the heart pump: it lowers blood pressure and makes the body pass more salt and water in the urine. According to the NHG, the heart's chambers make BNP and the inactive piece NT-proBNP, and extra when their wall comes under tension from too much pressure or fluid.

According to the NVKC, a strongly raised NT-proBNP points to heart failure, a reduced pumping function of the heart, and a low NT-proBNP rules out heart failure together with a normal ECG and physical examination. Only a blood test shows whether NT-proBNP is raised.

Unilabs uses 0 to 130 ng/l for women aged 18 to 45 and 0 to 249 ng/l for women aged 45 to 55; for men aged 18 to 45 it is 0 to 86 ng/l.

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
Laboratory	Group	Reference value (pmol/l)	Relative scale
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	· Female · 18–45 years	0–130 ng/l ng/l
Unilabs	· Female · 45–55 years	0–249 ng/l ng/l
Unilabs	· Female · 55–65 years	0–287 ng/l ng/l
Unilabs	· Female · 65–75 years	0–301 ng/l ng/l
Unilabs	· Female · 75–150 years	0–738 ng/l ng/l
Certe	· Everyone · 18 years and older · a limit, not a range	< 125 ng/L ng/L
Diagnostiek voor U	· Everyone · a limit, not a range	< 125 pg/mL 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

Unilabs gives in nanograms per litre (ng/l) how much NT-proBNP is in the blood, with an upper limit for women that rises per age group: 130 ng/l from 18 to 45, 249 ng/l from 45 to 55, 287 ng/l from 55 to 65, 301 ng/l from 65 to 75 and 738 ng/l from 75 to 150.

NT-proBNP: why this value matters

According to the NHG, men have lower NT-proBNP levels than women on average, and Unilabs gives separate limits for women and men. According to the NHG, GPs registered about 38,000 new patients with heart failure in 2018, slightly more women than men, and most of the women among them were older than 85.

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 NVKC, an NT-proBNP test is requested with symptoms of heart failure, such as shortness of breath, tiredness and swollen feet and legs. According to the NVKC, heart failure is harder to prove with mild symptoms and in older people, because small rises in NT-proBNP can also occur in healthy people.

NT-proBNP: symptoms of a high or low value

Low Levels

According to the NHG, a normal NT-proBNP makes heart failure unlikely when the ECG is normal as well. According to the NHG, obesity can lead to a lower NT-proBNP.

High Levels

According to the NHG, besides heart failure a raised NT-proBNP can also come from chronic kidney damage, atrial fibrillation or another rhythm disorder, a severe infection or older age. According to Thuisarts, in heart failure fluid can leak from the blood vessels, mainly into the lungs, the abdomen, the legs and the ankles.

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

Discuss an abnormal NT-proBNP with your GP. According to Thuisarts, someone with heart failure calls the GP, the out-of-hours GP service or 112 straight away when breathing suddenly becomes very fast or difficult, with sudden severe breathlessness or when lying down is no longer possible because of breathlessness, because there may then be fluid in the lungs.

NT-proBNP: frequently asked questions

Do women have a higher NT-proBNP than men?

Yes, according to the NHG men have lower NT-proBNP levels than women on average. Unilabs uses an upper limit of 738 ng/l for women aged 75 to 150 and 486 ng/l for men aged 75 to 150.

NT-proBNP: sources

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
Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
NHG-Standaard Hartfalen (M51), mei 2021, laatste aanpassing februari 2026, richtlijnen.nhg.org, geraadpleegd 2026-10-14 (retrieved 2026) richtlijnen.nhg.org
NVKC, Alles over testen: BNP of NTproBNP, allesovertesten.nl, geraadpleegd 2026-10-14 (retrieved 2026) allesovertesten.nl

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