NPPB and congestive heart failure: Drugs such as vasodilators and diuretics rapidly lower BNP in patients with acute heart failure [14], and angiotensin converting enzyme inhibitors [15] and beta-blockers [16] lower BNP in patients with chronic heart failure, and so the difference in BNP between patients with and without left ventricular systolic dysfunction in our study might have been greater if tested prior to commencing anti-failure medication.