If new scientific evidence was presented about a month ago Beta blockersIt is a medicine that has been used daily for decades for patients who have suffered from it Uncomplicated heart attacks – which is the majority -, and now a new international meta-analysis of five studies involving nearly 18,000 people has concluded again that beta-blocker drugs It provides no clinical benefit In patients who have normal heart function after a heart attack.
This is what was revealed by a huge study conducted by the National Center for Cardiovascular Research (CNIC), in cooperation with other international institutions, in which 17,801 patients participated from five studies, the results of which were published in the scientific journal ‘New England Journal of MedicineIt was presented at the American Heart Association (AHA) conference in New Orleans (USA).
The study confirms that beta-blockers, one of the most common treatments after acute myocardial infarction, do not reduce the risk of death, new infarctions, or heart failure in patients with normal systolic heart function. This has changed the treatment paradigm for cardiovascular disease. Below we gather everything that is known about this discovery so far:
What does this new study confirm?
The results of this new analysis are wide-ranging Confirming what the REBOOT clinical trial already indicated In Spain and Italy last August: These drugs that have been prescribed for 40 years after myocardial infarction offer no benefit to patients who regain normal heart function (more than 70% of the total).
This study was made possible thanks to the close collaboration between CNIC researchers and the authors of five clinical trials conducted in Spain, Denmark, Italy, Japan, Norway and Swedenwho shared their results in record time to provide a conclusive answer to a critical question for millions of patients around the world, as these drugs can Side effects such as fatigue, weakness or impotence. It is estimated that 1.2 million people in Spain eat it daily.
This work analyzed individual data from all contemporary clinical trials – “REBOOT” in Spain and Italy, “REDUCE-AMI” in Sweden, “BETAMI” in Norway, “DANBLOCK” in Denmark, and “CAPITAL-RCT” in Japan – that were performed on patients who had suffered a heart attack, but maintained normal heart function (ventricular ejection fraction) left). (LVEF) = 50%), which indicates that your heart is still working properly.
Results in detail
In the analysis, half of the participants received beta blockers while the other half did not. After a Follow up for approximately 4 years, around 8% of patients experienced a major cardiovascular event (such as death, new heart attack, or heart failure). This percentage was similar in both groups. Both in those who received beta blockers and in those who did not They took them.
The researchers also found that there was no benefit when analyzing separately deaths (total and cardiac), new heart attacks, heart failure, or serious arrhythmia. And the results were Similar in all patient groups, regardless of age, sex or type of beta-blocker used.
“This shows that there is no subgroup of post-infarction patients with normal heart function who would benefit from beta blockers,” noted Xavier Rosselló, a scientist at the CNIC and a cardiologist at the Son Espases Hospital in Mallorca, and first co-signer on the work.
Should I stop taking it?
Researchers confirm that beta blockers are very safe medications and have tremendous experience in using them No one should stop taking it without consulting a doctor during a medical examination.. “Beta blockers remain an essential treatment for patients with reduced left ventricular fraction after infarction or those with other diseases such as chronic heart failure or arrhythmia,” Ibanez stressed.
“These results do not mean that patients have been poorly treated so far, but rather show that the significant improvement in heart attack management in recent years makes beta blockers “It is no longer necessary from this point on” in patients with uncomplicated heart attacksHe pointed out.
In fact, the clinical trials that make up this large study did not include patients who were already taking beta blockers for another reason, e.g Heart failure or irregular heartbeatTheir conclusions therefore apply exclusively to the use of beta-blockers after infarction for normal cardiac function.
“Beta blockers should not be stopped for all patients without consulting a specialist doctor. The patient’s condition must be confirmed, and in addition, it must be taken into account that these medications can be taken for other indications, such as High blood pressure Or arrhythmia,” Ignacio Fernandez, president of the Spanish Society of Cardiology (SEC), which collaborated with the Spanish trial, explained to EFE.
Last September, after learning the results of the REBOOT study, the Spanish Association of Primary Care Physicians (Semergen) defended that beta-blockers are still necessary and part of standard treatment in patients with heart failure with low LVEF, angina pectoris, atrial fibrillation, myocardial infarction with complications and certain cases of hypertension with high heart rate.
Does it affect women to the same extent?
Unlike the REBOOT trial, which warned that use of beta blockers could be harmful even for women who overcome a heart attack with normal heart function, this potential negative effect does not appear consistent when all the trials are analyzed together.
“Although Women in this meta-analysis They have more adverse events When they were treated with beta blockers, which we already observed in “Reboot,” This difference is not relevant enough. “This may be due to differences in the interaction of beta-blockers with gender in southern Europe versus northern Europe, or for other reasons,” Ibanez says.
Paradigm shift
For more than 40 years, all patients who have had a heart attack have been treated with beta blockers for life, regardless of their heart function. This is because clinical trials conducted in the 1970s and 1980s showed the benefit of these drugs. However, the study authors point out that the management of infarction since then has changed radically and that the prognosis of patients has become much better since then, as they are less likely to develop malignant arrhythmias or heart failure.
The REBOOT clinical trial, led by CNIC, has already signaled a paradigm shift. “This meta-analysis indisputably confirms what REBOOT has already indicated: patients with normal cardiac function after a heart attack obtain no benefit from beta-blocker treatment,” they point out.
“This year, 2025, we have modified a paradigm in treating heart attacks that seemed unquestionable. From now on, patients discharged from the hospital after a heart attack with normal heart function will not receive beta blockersThis is one of the most important changes that have occurred in heart disease in recent decades. “We have suspected this for years, but until these studies we have not been able to provide an indisputable message like the one we present now,” highlighted another author, Valentin Foster, Director General of the CNIC, President of the Mount Sinai Foster Heart Hospital (USA) and researcher of both REBOOT and this meta-analysis.
Is it urgent that I go to the doctor if I take this medicine?
The researchers stress that it is important not to panic, because beta blockers are very safe medications and there is tremendous experience in their use. They add: “No one should stop taking these medications without consulting a doctor.”
“You should consult a doctor because you may be taking beta blockers for a reason other than a heart attack and you should continue to do so. The consultation should not be urgent, but rather when it is time for a review.. “If the doctor confirms that you are taking beta-blockers exclusively because you have had a heart attack and your heart function is normal, beta-blocker treatment will almost certainly be withdrawn.”
For researchers, this work will have a major impact on clinical practice guidelines around the world, and as Foster explains, “this study joins other studies also coordinated by the CNIC, such as PESA, SECURE or DapaTAVI that are changing clinical practice around the world.”
What are the harmful effects?
According to the authors, beta blockers, although there are Very high security profileare not exempt from potential adverse effects that, although not considered serious, can somewhat limit the quality of life of patients.
Symptoms such as Fatigue, exhaustion or impotence It may appear in some patients receiving beta-blocker treatment. Therefore, they highlight that the results of this study can have a positive impact on this group of patients.
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