NEW YORK, Aug 31: A new study has raised concerns over the use of beta-blockers, a long-standing treatment for heart attack patients, revealing that the drugs may not only be ineffective for the majority of patients but may also increase the risk of hospitalization and death for some women. These findings could potentially revolutionize international clinical guidelines and spark a necessary, sex-specific approach to cardiovascular treatment.

Beta-blockers, which have been standard post-heart attack care for decades, were found to offer no significant benefits for most patients with preserved heart function and could even be harmful to women, according to a study published in the European Heart Journal and set to be presented at the European Society of Cardiology Congress in Madrid this weekend.

The research focused on women who had minimal heart damage following a heart attack and were treated with beta-blockers. These women were shown to have a significantly higher likelihood of experiencing a second heart attack, being hospitalized for heart failure, or even dying — up to three times more likely compared to women not receiving the drug. The negative effects were particularly pronounced in women who were given higher doses of beta-blockers.

"This is the largest clinical trial ever to examine the use of beta-blockers following heart attacks in women," said Dr. Borja Ibáñez, the study's lead author and scientific director at the National Center for Cardiovascular Investigation in Madrid. "The findings are significant because they challenge decades of standard practice."

The study’s conclusions applied to women with a left ventricular ejection fraction (LVEF) greater than 50%, a measure of heart function indicating normal pumping ability. For women with lower LVEF, below 40%, beta-blockers remain standard treatment due to their ability to manage arrhythmias, which can trigger another heart attack.

In contrast, men did not appear to experience the same risks from beta-blockers, with the drug continuing to be beneficial for most male patients with heart damage.

Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, who was not involved in the research, noted the gender-specific response to medications. "Women have smaller hearts and may be more sensitive to blood pressure medications like beta-blockers," Freeman explained. "There are still factors we don’t fully understand, but gender plays a major role in how people respond to treatment."

Beta-blockers, in use for over 40 years, have been a cornerstone treatment for heart attack patients. However, the new findings suggest they may be less effective than once believed, particularly as modern treatments, such as stents and blood thinners, have improved survival rates.

The study, part of the extensive REBOOT trial, followed 8,505 patients from 109 hospitals in Spain and Italy for nearly four years. The findings contradict long-standing medical guidelines that still recommend beta-blockers for most heart attack survivors, despite new advancements in heart disease treatment.

Dr. Valentin Fuster, senior study author and president of Mount Sinai Fuster Heart Hospital in New York, stated, "Our research shows no benefit for beta-blockers in patients with preserved heart function after a heart attack. This will force a reevaluation of treatment protocols for both men and women."

Despite these revelations, a separate meta-analysis of 1,885 patients published in The Lancet found benefits for those with LVEF between 40% and 50%, where the heart may experience mild damage. For this subgroup, beta-blockers helped reduce the risk of new heart attacks, heart failure, and death by 25%.

"These findings highlight the need for a more nuanced approach to post-heart attack treatment," said Ibáñez. "Beta-blockers should not be routinely used for patients with good heart function, but for those with moderate damage, they continue to offer significant benefits."

The study also emphasizes the importance of reassessing older treatments as new, more effective interventions emerge. With current heart attack survival rates improving, clinicians are urged to reconsider the long-standing use of beta-blockers for patients with preserved heart function.

These findings may lead to major changes in the way heart disease is treated and are expected to influence clinical guidelines globally, pushing for more tailored, sex-specific cardiovascular care.