AF is present in about 40% of participants with HFpEF and is associated with higher N-terminal pro b-type natriuretic peptide (NT-proBNP) levels, risk of death and hospital admission with HF.7–10 In the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme, AF was associated with increased risk of death or hospitalisation for worsening HFpEF (HR 1.72, 95% CI 1.45 to 2.06 for adverse cardiovascular outcomes).8 The gene discussed is NPPB; the disease is atrial fibrillation.