NT-proBNP’s limited diagnostic accuracy for LV dysfunction in the very old is likely to reflect the high prevalence of other cardiac and non-cardiac morbidities known to elevate natriuretic peptides, [11] compounded by the high consumption of medications (for co-morbid conditions such as hypertension) which can potentially lower peptides below threshold levels even in the presence of LV dysfunction [7]. This evidence concerns the gene NPPB and hypertensive disorder.