Low quality evidence was also found for the outcomes QoL as measured by the KCCQ (n=250), worsening renal function (n=849), hypotension (n=1114) and atrial fibrillation (n=151) all of which showed no clinical effect of NP monitoring. Very low quality evidence was found for the outcome hospitalisations reported as rate ratio (n=69) which suggested a clinically important decrease with NP monitoring. Further very low quality evidence was found for the outcome HF hospitalisation. When reported as a hazard ratio (n=1515) and risk ratio (n=52) the outcome showed a clinically important reduction with NP monitoring monitoring (associated with wide confidence intervals around the effect estimate). When reported as a rate ratio (n=894) the evidence suggested a clinically important increase in the number of HF hospitalisations with NP monitoring. For the outcomes creatinine rise >30% (n=220), acute kidney injury (n=151), hyperkalaemia (n=894), and significant ventricular arrhythmia (n=151) there was no suggestion of a clinically important effect on these outcomes. Age <75 years: Moderate quality evidence was found for the outcome hospitalisation (n=572) which suggested a clinically important reduction with NP monitoring. Low quality evidence was found for the outcomes mortality (n=1234) which suggested a clinically important reduction in deaths with NP monitoring. Further low quality evidence was found for the outcomes acute kidney injury (n=210) and bradycardia (n=210) both of which suggested no clinical effect of NP monitoring. Very low quality evidence was found for the outcome hyperkalaemia (n=210) which suggested no clinical effect of NP monitoring, and hypotension (n=210) which suggested a clinical harm with NP monitoring. Age 75 years: Moderate to very low quality evidence was found for the outcomes hospitalisations (n=598), mortality (n=1254), hyperkalaemia (n=289) and hypotension (n=289) . Hospitalisations and hyperkalaemia suggested a clinically important increase with NP monitoring (all associated with wide Chronic Heart Failure Monitoring NICE 2018. 