Heart failure is a major public health problem. The clinical diagnosis is imprecise and a simple test of left ventricular function would greatly improve diagnostic accuracy. Measurement of brain natriuretic peptide (BNP) has been shown in some studies to be a potential marker of left ventricular dysfunction.1 Heart failure is more common in the elderly and is often treated in the community where a simple test would be of considerable benefit. We have therefore measured plasma BNP values and compared them with echocardiographic measures of left ventricular function in a large, community based population.

Eight general practices of a total list size of 65 820 were surveyed. All patients currently prescribed loop diuretics were invited to take part in the study as it was thought the majority of patients with the clinical syndrome of heart failure would be treated with them. Of the 1425 patients asked to participate, informed consent, echocardiograms, and measurement of plasma BNP were obtained in 653. The median age of the group was 76 years with an interquartile range (IQR) of 70–82 years. The group was composed of 254 males and …