Cardiac natriuretic peptides (NP), atrial NP (ANP) and B-type NP (BNP) are produced and released by cardiomyocytes and have endocrine function. Conversely, C-type NP (CNP) is produced by mesenchymal cells, like endothelial cells, and has paracrine and autocrine effects. These peptides are recognised as crucial in regulating metabolic and cardiovascular homeostasis. In population studies, genetic variants of NP genes or their receptors, resulting in higher NP activity, are associated with lower blood pressure (BP) and better lipid profile with reduced susceptibility to hypertension, diabetes and obesity. NPs carry out both strictly cardiovascular effects, such as anti-fibrotic and anti-hypertrophic effects, vasodilatation, natriuresis and inhibition of the renin-angiotensin-aldosterone system (RAAS), and metabolic effects, such as increased lipolysis, energy expenditure, enhanced lipid oxidation, browning white adipocytes, decreased inflammatory cytokines and insulin resistance (Sarzani et al., 2017; Spannella et al., 2019). All these systemic actions are mainly driven by the binding of ANP and BNP to the NP receptor A (NPR-A), a transmembrane receptor expressed in many tissues, inducing the intracellular generation of the second messenger cyclic guanosine monophosphate (cGMP), which activates multiple targets in its downstream cascade. On the other side, neprilysin, a ubiquitous zinc-dependent membrane metalloendopeptidase expressed mainly in smooth muscle cells, endothelial cells, cardiac myocytes, fibroblasts and kidneys, and NP receptor C (NPR-C), a clearance receptor highly expressed in This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.