In the Aliskiren Observation of Heart Failure Treatment (ALOFT) study, patients with New York Heart Association class II-IV heart failure, a current or past history of hypertension, and plasma brain naturetic peptide (BNP) > 100 pg/mL were randomized to 3 months of treatment with aliskiren 150 mg/d (n = 156) or placebo (n = 146) [15]. Here, NPPB is linked to heart failure.