Background and Objectives: There is clear evidence that urinary albumin excretion levels as a maker of generalized vascular damage and B-type natriuretic peptide (BNP) from cardiac overload are associated with an increased risk of cardiovascular (CV) events. It is possible that the relationship of this biomarker with a variety of risk factors may contribute to explain the enhanced cardiovascular risk. We aimed to estimate relationship and ability of BNP and microalbuminuria (MAU) for identifying high risk patient of cardiovascular disease. Subjects and methods: We included 1451 adult subjects (males: 42.0%, mean age: 55.5짹8.3 years) of a community-based cohort from Korea Rural Genomic Cohort (KRGC) Study. We obtained information for level of N-terminal proBNP (NT-proBNP, Roche), MAU level from spot urine and clinical characteristics. High risk patient was defined as subject with diabetes, coronary heart disease, or a cerebrovascular event. We exclude significant renal failure (11 participant who have >2.0 mg/dl of serum creatinine). Results: Among the 1451 subject, albuminuria distribution according to definition by albumin/creatinine ratio (mg/g) was as follow; normal (male <10, female <15, 74.6%), high normal (male 10-20, female 15-30, 13.0%), MAU (male 20-200, female 30-300, 10.8%) and macroalubuminuria (male >200, female >300, 1.6%). And, the distribution of MAU and high NT-proBNP according to risk factors showed in table 1. The regression analysis showed the levels of NT-proBNP were positively and significantly correlated with MAU after adjustment age, sex, CRP, systolic blood pressure, waist circumference and creatinine (B=0.08517, p=0.0337). Receiver-operating characteristic (ROC) areas under the curve (AUCs) for MAU and NT-proBNP to identify high risk patient was 0.711 and 0.821 respectively. Conclusion: The levels of blood NT-proBNP and urine albumin/creatinine ratio were associated with risk factors but, distribution pattern was different. Therefore, these 2 markers may serve a cooperative and adjuvant tool for the identification of high risk group in general population.