The relatively low NT-proBNP levels in our study population consisting primarily of comorbidity-driven HFpEF patients, may thus be explained by: (1) study design criteria with recruitment of a chronic, stable outpatient HFpEF population and exclusion of cardiomyopathies; (2) recruitment of a subgroup of HFpEF patients who may be in an earlier stage of myocardial disease progression because elevated NT-proBNP was not compulsory for HFpEF diagnosis; and (3) the predominance of elderly, postmenopausal women with high prevalence of cardiometabolic risk factors. This evidence concerns the gene NPPB and myocardial disorder.