{"id":402769,"date":"2025-09-06T13:45:18","date_gmt":"2025-09-06T13:45:18","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/402769\/"},"modified":"2025-09-06T13:45:18","modified_gmt":"2025-09-06T13:45:18","slug":"after-40-years-heart-doctors-say-beta-blockers-may-do-more-harm-than-good","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/402769\/","title":{"rendered":"After 40 Years, Heart Doctors Say Beta Blockers May Do More Harm Than Good"},"content":{"rendered":"

\t\t\"Cardiology<\/a>A groundbreaking international trial has found beta blockers don\u2019t help most heart attack patients with preserved heart function, despite being standard care for decades. Even more concerning, women given the drug faced higher risks of death and complications. Credit: Stock<\/p>\n

For over 40 years, beta blockers have been prescribed to heart attack survivors as a standard treatment. But the massive REBOOT trial has revealed they provide no benefit for patients with preserved heart function \u2014 and may actually increase risks for women.<\/p>\n

Standard Treatment Questioned After 40 Years<\/p>\n

Beta blockers, commonly prescribed for heart conditions including heart attacks, have now been shown to offer no measurable benefit for patients who experience an uncomplicated myocardial infarction while maintaining normal heart function. Despite being recommended for this group for four decades, their effectiveness in such cases is now being called into question.<\/p>\n

The finding comes from the REBOOT Trial, a major study led by Valentin Fuster, MD, PhD, President of Mount Sinai Fuster Heart Hospital and General Director of Spain\u2019s Centro Nacional de Investigaciones Cardiovasculares (CNIC). The results, which challenge one of cardiology\u2019s longest-standing practices, were presented on August 30, during a \u201cHot Line\u201d session at the European Society of Cardiology Congress in Madrid and published at the same time in The New England Journal of Medicine.<\/p>\n

Higher Risks for Women Exposed<\/p>\n

A companion substudy of REBOOT, released the same day in the European Heart Journal, revealed an important difference between men and women. Women who were treated with beta blockers after a heart attack faced a higher likelihood of dying, suffering another heart attack, or being hospitalized for heart failure when compared with women who did not receive the medication. This increased risk was not observed in men.<\/p>\n

\u201cThis trial will reshape all international clinical guidelines. It joins other previous landmark trials led by CNIC and Mount Sinai \u2013 such as SECURE with the polypill and DapaTAVI, with SLT2 inhibition associated to TAVI \u2013that have already transformed some global approaches to cardiovascular disease,\u201d says Dr. Fuster.<\/p>\n

\"Valentin<\/a>Valentin Fuster, MD, PhD. \u201cREBOOT Trial\u201d shows beta blockers\u2014drugs commonly prescribed for heart attacks\u2014may offer no clinical benefit for these patients. Credit: Mount Sinai Health System<\/p>\n

The SECURE trial showed a polypill, a single pill that combines three medications \u2013 which contains aspirin, ramipril, and atorvastatin \u2013 reduces cardiovascular events by 33 percent in patients treated with this after a heart attack. The DapaTAVI trial showed that both dapagliflozin and the related medication empagliflozin \u2013 drugs used to treat diabetes \u2013 improve the prognosis of patients with aortic stenosis treated by transcatheter aortic valve implantation.<\/p>\n

Global Impact on Heart Attack Care<\/p>\n

\u201cREBOOT will change clinical practice worldwide,\u201d says Principal Investigator Borja Ib\u00e1\u00f1ez, MD, CNIC\u2019s Scientific Director, who presented the results. \u201cCurrently, more than 80 percent of patients with uncomplicated myocardial infarction are discharged on beta blockers. The REBOOT findings represent one of the most significant advances in heart attack treatment in decades.\u201d<\/p>\n

Although generally considered safe, beta blockers can cause side effects such as fatigue, bradycardia (low heart rate), and sexual dysfunction. 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. The REBOOT trial, is the largest clinical trial on this subject. The international study was coordinated by CNIC in collaboration with the Mario Negri Institute for Pharmacological Research in Milan.<\/p>\n

Largest Beta Blocker Study to Date<\/p>\n

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.<\/p>\n

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 percent 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 completely normal cardiac function after a heart attack (left ventricular ejection fraction of 50 percent or higher). Those with a mild deterioration in cardiac function did not have an excess risk of adverse outcomes when treated with beta-blockers.<\/p>\n

Why the Old Standard No Longer Fits<\/p>\n

\u201cAfter a heart attack, patients are typically prescribed multiple medications, which can make adherence difficult,\u201d explains Dr. Ib\u00e1\u00f1ez. \u201cBeta blockers were added to standard treatment early on because they significantly reduced mortality at the time. Their benefits were linked to reduced cardiac oxygen demand and arrhythmia prevention. But therapies have evolved. Today, occluded coronary arteries are reopened rapidly and systematically, drastically lowering the risk of serious complications such as arrhythmias. In this new context, where the extent of heart damage is smaller, the need for beta blockers is unclear. While we often test new drugs, it\u2019s much less common to rigorously question the continued need for older treatments.\u201d<\/p>\n

REBOOT Trial Motivation<\/p>\n

That was the motivation behind REBOOT.<\/p>\n

\u201cThe trial was designed to optimize heart attack care based on solid scientific evidence and without commercial interests. These results will help streamline treatment, reduce side effects, and improve quality of life for thousands of patients every year,\u201d Dr. Ibanez adds.<\/p>\n

References:<\/p>\n

\u201cBeta-Blockers after Myocardial Infarction without Reduced Ejection Fraction\u201d by Borja Ibanez, Roberto Latini, Xavier Rossello, Alberto Dominguez-Rodriguez, Felipe Fern\u00e1ndez-Vazquez, Valentina Pelizzoni, Pedro L. S\u00e1nchez, Manuel Anguita, Jos\u00e9 A. Barrab\u00e9s, Sergio Raposeiras-Roub\u00edn, Stuart Pocock, Noem\u00ed Escalera, Lidia Staszewsky, Carlos Nicol\u00e1s P\u00e9rez-Garc\u00eda, Pablo D\u00edez-Villanueva, Jose-Angel P\u00e9rez-Rivera, Oscar Prada-Delgado, Ruth Owen, Gonzalo Pizarro, Onofre Caldes, Sandra G\u00f3mez-Talavera, Jos\u00e9 Tu\u00f1\u00f3n, Matteo Bianco, Jesus Zarauza, Alfredo Vetrano, Ana Campos, Susana Mart\u00ednez-Huertas, H\u00e9ctor Bueno, Miguel Puentes, Giulietta Grigis, Juan L. Bonilla-Palomas, Elvira Marco, Jos\u00e9 R. Gonz\u00e1lez-Juanatey, Roi Bangueses, Carlos Gonz\u00e1lez-Juanatey, Ana Garc\u00eda-\u00c1lvarez, Juan Ruiz-Garc\u00eda, Anna Carrasquer, Juan C. Garc\u00eda-Rubira, Domingo Pascual-Figal, Carlos Tom\u00e1s-Querol, J. Alberto San Rom\u00e1n, Pasquale Baratta, Jaume Ag\u00fcero, Roberto Mart\u00edn-Reyes, Furio Colivicchi, Rosario Ortas-Nadal, Pablo Bazal, Alberto Cordero, Antonio Fern\u00e1ndez-Ortiz, Pierangelo Basso, Eva Gonz\u00e1lez, Fabrizio Poletti, Giulia Bugani, Marzia Debiasio, Deborah Cosmi, Alessandro Navazio, Javier Bermejo, Giovanni Tortorella, Marco Marini, Javier Botas, Jos\u00e9 M. de la Torre-Hern\u00e1ndez, Filippo Ottani and Valent\u00edn Fuster, 29 August 2025, New England Journal of Medicine.
DOI: 10.1056\/NEJMoa2504735<\/a><\/p>\n

\u201cBeta-blockers after myocardial infarction: effects according to sex in the REBOOT trial\u201d by Xavier Rossello, Alberto Dominguez-Rodriguez, Roberto Latini, Pedro L S\u00e1nchez, Sergio Raposeiras-Roub\u00edn, Manuel Anguita, Jos\u00e9 A Barrab\u00e9s, Giulietta Grigis, Ruth Owen, Stuart Pocock, Sandra G\u00f3mez-Talavera, Ines Garc\u00eda-Lunar, Noem\u00ed Escalera, Carlos Nicol\u00e1s P\u00e9rez-Garc\u00eda, Stefania Angela Di Fusco, Gonzalo Pizarro, Mar\u00eda L\u00f3pez Benito, Giulia Pongetti, Luis M Rinc\u00f3n-D\u00edaz, Irene Buera, Jos\u00e9 Rozado, Mar\u00eda Jes\u00fas Garc\u00eda, Oscar Prada-Delgado, Deborah Cosmi, Valent\u00edn Fuster and Borja Ibanez, 30 August 2025, European Heart Journal.
DOI: 10.1093\/eurheartj\/ehaf673<\/a><\/p>\n

Meeting: ESC Congress 2025<\/p>\n

REBOOT was conducted without pharmaceutical industry funding.<\/p>\n

Never miss a breakthrough: Join the SciTechDaily newsletter.<\/a><\/b><\/p>\n","protected":false},"excerpt":{"rendered":"A groundbreaking international trial has found beta blockers don\u2019t help most heart attack patients with preserved heart function,…\n","protected":false},"author":2,"featured_media":402770,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[6441,105,301,11023,138866,5489,16,15],"class_list":{"0":"post-402769","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-cardiology","9":"tag-health","10":"tag-heart","11":"tag-mount-sinai-hospital","12":"tag-mount-sinai-school-of-medicine","13":"tag-pharmaceuticals","14":"tag-uk","15":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/115157658876080884","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/402769","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=402769"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/402769\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/402770"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=402769"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=402769"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=402769"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}