Heart failure has a prevalence of up to 22 % in people with diabetes1, and CVD is the major cause of morbidity and mortality in this population.2 The risk of life-threatening CVD in diabetes is elevated by the coexistence of hypertension, with a prevalence of 85 % in individuals with type 2 diabetes by the fifth decade of life, according to the San Antonio Heart Study.3

Currently, heart failure is defined as a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated levels of natriuretic peptides and/or objective evidence of pulmonary or systemic congestion.4 Therefore, recent practical guidelines recommend the measurement of natriuretic peptides to support or exclude heart failure screening.5., 6., 7. Particularly among individuals with diabetes, the measurement of a natriuretic peptide is recommended on at least a yearly basis, to identify early heart failure stages and implement strategies to prevent transition to symptomatic stages.8

Among natriuretic peptides, measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), the inactive N-terminal fragment released upon enzymatic cleavage of the hormone pro-B-type natriuretic peptide, offers advantages. NT-proBNP has only a passive excretion, mainly by the kidney, has a longer half-life than the biologically active molecule B-type natriuretic peptide (120 vs. 20 min.), and higher plasma concentrations (approximately 6 times more).9 A plasma concentration of NT-proBNP <125 pg/ml makes a diagnosis of heart failure unlikely6, whereas a value equal or above this cutoff suggests heart failure with recommendations for confirmation by echocardiography.6

Testing of NT-proBNP in primary care is available either by recurring to laboratory analysis or by directly point-of-care (POC) measurement. The aim of this pragmatic observational study was to identify the proportion of patients with type 2 diabetes and hypertension, and no overt cardiovascular disease, with a value of NT-proBNP ≥125 pg/ml in the diabetology care setting, through the measurement of NT-proBNP by using a POCT system.