Beta Blockers Offer Little Benefit for Heart Attack Patients with Healthy Hearts

According to a large study conducted in Spain and Italy, beta blockers, drugs often used to slow the heart rate and lower blood pressure, did not provide clear benefits for heart attack patients whose hearts were still functioning well. The results of the REBOOT trial, published in the New England Journal of Medicine on August 30, 2025, and presented at the European Society of Cardiology Congress in Madrid, showed no significant difference in rates of death, repeat heart attacks, or hospitalization for heart failure between patients who took beta blockers and those who did not.

Interestingly, a subanalysis of the REBOOT study found that beta blockers were associated with an increased risk of death from all causes for the approximately 1,600 women enrolled, compared to women who were not taking the medication. In contrast, no excess risk was found in men. However, the authors cautioned that the women in the study were generally older and sicker than the male participants.

Meanwhile, another clinical trial called BETAMI-DANBLOCK, also published on August 30, 2025, in the New England Journal of Medicine, suggested potential benefits of beta blockers. This study of over 5,000 heart attack patients with mildly decreased or intact heart function found that those treated with beta blockers had fewer new heart attacks during the 3.5-year study period compared to those who did not take the medication. But there was no difference in rates of death, heart failure, stroke, or other major heart issues between the two groups.

Experts say the REBOOT study, with its larger sample size and more rigorous protocol, provides a cleaner look at the role of beta blockers in this patient population. They suggest that with the advancements in medical therapies and procedures for heart attacks over the past decade or two, the long-standing guidance on beta blocker use may need to be reconsidered.