BNP/NT-proBNP Cutoffs Stratified for PH (Calculator)

Value Enter numeric value in ng/L (e.g., 275 or 275.5). Risk Model -- choose -- ESC/ERS 3-Strata (Low / Intermediate / High) COMPERA 2.0 Four-Strata (Low / Intermediate-Low / Intermediate-High / High) BNP/NT-proBNP Cutoffs in Pulmonary Hypertension: Explanation and Clinical Context Brain natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) are key biomarkers of right ventricular strain and adverse prognosis in pulmonary arterial hypertension (PAH). Contemporary risk assessment frameworks use peptide thresholds alongside clinical (WHO functional class), exercise (6-minute walk distance), imaging, and hemodynamic data to estimate 1-year mortality risk and to guide therapy escalation.

The ESC/ERS 2022 guideline three-strata approach defines low risk when BNP is <50 ng/L or NT-proBNP is <300 ng/L; intermediate risk at BNP 50–800 ng/L or NT-proBNP 300–1100 ng/L; and high risk when BNP >800 ng/L or NT-proBNP >1100 ng/L. The COMPERA 2.0 model refines peptide cutoffs into four strata: for BNP <50 (low), 50–199 (intermediate-low), 200–800 (intermediate-high), >800 ng/L (high); and for NT-proBNP <300 (low), 300–649 (intermediate-low), 650–1100 (intermediate-high), >1100 ng/L (high). In COMPERA registry analyses, this four-strata scheme better separated long-term survival—particularly distinguishing intermediate-low from intermediate-high risk—and aligned more closely with clinically meaningful changes between visits.

In practice, values in the intermediate-high or high ranges should prompt reassessment of therapy and closer follow-up, whereas achieving or maintaining low values supports a favorable risk profile when corroborated by other parameters.