Beta blockers may offer no benefit for heart attack patients, and women can have worse outcomes

Medical Xpress / The Mount Sinai Hospital / New England Journal of Medicine ^ | Aug. 30, 2025 | Valentin Fuster, MD, Ph.D. et al

[ConservativeMind]

Beta blockers—drugs commonly prescribed for a range of cardiac conditions, including heart attacks—provide no clinical benefit for patients who have had an uncomplicated myocardial infarction with preserved heart function. Beta blockers have been the standard treatment for these patients for 40 years.

This is a breakthrough discovery from the "REBOOT Trial."

Additionally, a REBOOT substudy, shows that women treated with beta blockers had a higher risk of death, heart attack, or hospitalization for heart failure compared to women not receiving the drug. Men did not have this increased risk.

Says Borja Ibáñez, MD.l, "Currently, more than 80% of patients with uncomplicated myocardial infarction are discharged on beta blockers."

For more than 40 years, beta blockers have been prescribed as a standard treatment after a heart attack, but their benefit in the context of modern treatments was unproven.

Researchers enrolled 8,505 patients across 109 hospitals in Spain and Italy. Participants were randomly assigned to receive or not receive beta blockers after hospital discharge. All patients otherwise received the current standard of care and were followed for a median of nearly four years. The results showed no significant differences between the two groups in rates of death, recurrent heart attack, or hospitalization for heart failure.

A REBOOT subgroup analysis found that women treated with beta blockers experienced more adverse events. Results show women treated with beta-blockers had a 2.7% higher absolute risk of mortality compared to those not treated with beta-blockers during the 3.7 years of follow-up of the study.

The elevated risk when treated with beta-blockers was restricted to women with a complete normal cardiac function after a heart attack (left ventricular ejection fraction of 50% or higher). Those with a mild deterioration in cardiac function did not have an excess risk of adverse outcomes when treated with beta-blockers.

[ConservativeMind]

Beta-blockers are not helpful for uncomplicated myocardial infarction with preserved heart function, and appear to even hurt women with normal heart function after a heart attack.

That’s one less drug to take!

[ConservativeMind]

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[Red6]

This needs censored.

Big pharma won’t be happy.

[bobbytunes]

Trust the science . God created us, foolish men think they know better.

[kawhill]

I just chew up two 81mg baby aspirin every morning and don’t worry about it too much.

[SunkenCiv]

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[wardaddy]

Do you have proven heart disease?

[Jacquerie]

Good for patients to know.

However, I doubt that the cardiologists who’ve prescribed them for decades will change their habits.

No one looks out better for our health than ourselves.