Although measurement of natriuretic peptides is FDA-approved for several indications, their relevance to primary prevention of cardiovascular disease as an adjunct to established risk factors remains uncertain. Our recently published literature-based meta-analysis reported a relative risk of 2.8 (95% confidence interval, 2.4 to 3.3) for cardiovascular disease in individuals in the top third versus those in the bottom third of NPs values. This promising preliminary finding was, however, critically limited by lack of access to individual participant data.

The Natriuretic Peptides Studies Collaboration (NPSC), a central database of prospective studies that measured natriuretic peptides in the general population, will enable us to reliably characterise the shape of any dose-response relationships between circulating levels of natriuretic peptides and cardiovascular risk. It will further help to explore associations in various subgroups (e.g. in women and men, by age groups), shed light on potential reasons for diverse associations across studies (e.g. type of natriuretic peptide, length of follow-up, geographic region) and will allow comparison of association strength with various non-vascular fatal outcomes. Of note, the Natriuretic Peptides Studies Collaboration provides the ideal framework to evaluate to which extent natriuretic peptides may be useful for predicting cardiovascular risk in the general population, when added to established cardiovascular risk scores.