For more than four decades, doctors have prescribed beta blockers as a standard step after heart attacks. These drugs slow heart rate and lower blood pressure. They were originally believed to reduce the risk of a second heart attack or death. Today, two new studies place that long-standing practice under close examination.

Study One: REBOOT Raises Doubts

The first study, called REBOOT, involved over 8,400 patients across Spain and Italy whose heart function remained strong, with ejection fraction over 40 percent. Participants either received beta blockers or no treatment shortly after hospital discharge. After about 3.7 years, there was no difference between the groups in overall death rates, repeat heart attacks, or hospital stays for heart failure.

In a closer look at female participants, about 1,600 women, a concerning pattern emerged. Women on beta blockers had a higher risk of death from any cause than those who did not receive the medication. No similar trend appeared in men. Researchers cautioned that these women tended to be older, sicker, and received less aggressive treatment overall than men, which makes it difficult to draw a firm conclusion.

Study Two: BETAMI-DANBLOCK Offers a Different View

The BETAMI-DANBLOCK trial studied more than 5,000 people with mild or intact heart function. It found that those taking beta blockers had fewer non-fatal later heart attacks over about 3.5 years. However, this did not result in fewer deaths, strokes, or other major heart complications.

Experts suggested that this outcome may be shaped by how the data was gathered. The trial combined two smaller studies that could not enroll enough patients when conducted separately, so the methods varied between countries. This raises questions about how reliable the findings may be.

What This All Means

REBOOT appeared more tightly designed, with clearer rules for who was included. It challenges a routine therapy doctors have followed for decades, especially since modern treatments such as advanced stents and improved heart care have reshaped the context in which beta blockers were first tested.

Some doctors now believe that for patients with preserved heart function and no other reason to use beta blockers, the drugs may provide little benefit and could even pose risks for certain groups, such as older women in specific situations.

Next Steps for Doctors and Patients

These studies do not suggest that patients should stop taking beta blockers on their own. Any changes must be made through careful medical evaluation. What they do highlight is the need to move away from a universal rule in heart attack care.

Adjusting treatment to suit the individual, instead of following tradition by default, feels overdue. By tailoring care based on new data, doctors can reduce unnecessary medications, limit side effects, and improve outcomes. This points toward a future where prescriptions are more precise and thoughtful, rather than shaped by practices of the past.