Beta Blockers for Heart Attack Survivors: May Have No Benefit for Most, Could Actually Harm Women (cnn.com)
- Reference: 0178957534
- News link: https://science.slashdot.org/story/25/08/31/1854245/beta-blockers-for-heart-attack-survivors-may-have-no-benefit-for-most-could-actually-harm-women
- Source link: https://www.cnn.com/2025/08/30/health/heart-attack-beta-blockers-wellness
> Women with little heart damage after their heart attacks who were treated with beta-blockers were significantly more likely to have another heart attack or be hospitalized for heart failure — and nearly three times more likely to die — compared with women not given the drug, according to a study [2]published in the European Heart Journal and also scheduled to be presented Saturday at the European Society of Cardiology Congress in Madrid... The findings, however, only applied to women with a left ventricular ejection fraction above 50%, which is considered normal function, the study said. Ejection fraction is a way of measuring how well the left side of the heart is pumping oxygenated blood throughout the body. For anyone with a score below 40% after a heart attack, beta-blockers continue to be the standard of care due to their ability to calm heart arrhythmias that may trigger a second event...
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> The analysis on women was part of a much larger clinical trial called REBOOT — Treatment with Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction — which followed 8,505 men and women treated for heart attacks at 109 hospitals in Spain and Italy for nearly four years. Results of the study were [3]published in Mem>The New England Journal of Medicine and also presented at the European Society of Cardiology Congress. None of the patients in the trial had a left ventricular ejection fraction below 40%, a sign of potential heart failure. "We found no benefit in using beta-blockers for men or women with preserved heart function after heart attack despite this being the standard of care for some 40 years," said Fuster, former editor-in-chief of the Journal of the American College of Cardiology and past president of the American Heart Association and the World Health Federation... In fact, most men and women who survive heart attacks today have ejection fractions above 50%, Ibáñez said [Dr. Borja Ibáñez, scientific director for Madrid's National Center for Cardiovascular Investigation]. "Yet at this time, some 80% of patients in the US, Europe and Asia are treated with beta-blockers because medical guidelines still recommend them...."
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> While the study did not find any need to use beta-blockers for people with a left ventricular ejection fraction above 50% after a heart attack, a separate meta-analysis of 1,885 patients published Saturday in The Lancet did find benefits for those with scores between 40% and 50%, in which the heart may be mildly damaged. "This subgroup did benefit from a routine use of beta-blockers," said Ibáñez, who was also a coauthor on this paper. "We found about a 25% reduction in the primary endpoint, which was a composite of new heart attacks, heart failure and all-cause death."
[1] https://www.cnn.com/2025/08/30/health/heart-attack-beta-blockers-wellness
[2] https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehaf655
[3] https://www.nejm.org/doi/full/10.1056/NEJMoa2504735
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I'm not sure if you are being facetious or not.
There has been discussion in cardiology circles for the past decade that beta blockers likely should play a smaller role in the post-MI (myocardial infarction == heart attack) care.
Beta blockers were initially prescribed post-MI to reduce the amount of arrhythmias post-MI. That being said, with the advent of early revascularization post-MI with patients going to the cath lab earlier rather than later (or never), the paradigm has shifted. The early revasculariz
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This speaks to how dumb RFK is as he is cutting so many of our research programs like this which is important things like checking on the viability of treatments after years or decades and methodology has improved which is a thing a drug company doesnt have an incentive to do unless we regulate it in place and even then the government can be fully public with its data.
This study was funded and performed by CNIC which is a research agency part of the Spanish government.
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I can't tell if you're being heavily sarcastic, or if you really believe all the self-contradictory claptrap in your post!
Re: We need RFK Jr on the case (Score:2)
Yeah, Poe's law applies. ðYðY(TM)f
Re: (Score:2)
This guy you're describing, RFK...isn't he the one who thinks vaccines are overrated? That is despite the fact that research has proven over and over again how effective they are? The same guy who thought ivermectin was effective against COVID? OK if that's what you call a "valuable correction" then OK. yeah.
Re: We need RFK Jr on the case (Score:2)
I think I've provided a proof of Poe's Law
Retesting old dogma... (Score:3)
(I am a cardiologist)
This is an interesting thing, and needs to be followed closely.
There are a group of medications that have been made the standard of care for the treatment of a heart attack. These medications were tested in numerous high quality trials (randomized, double blind, placebo-control). But many of the trials are old. They don't take modern practices into account.
The problem with "just repeat the trials" is that trials are both hard and expensive. Expensive to get enough people enrolled in them and followed for a long enough time to get a good outcome. Hard because it's hard to enroll someone who is in the acute phase of a heart attack into a trial. Doubly hard if you are trying to test something that was previously believed to be the standard of care.
Imagine being a patient and being offered "We have this medication that we want to test whether it's going to help you after your heart attack. Would you be willing to be in a trial, where you are not sure if you are going to get the medication or not? If you don't want to be in the trial, you will almost definitely get the medication, because it's considered a lifesaving medication after a heart attack."
These trials are great and I give props to the study authors and their team to tease out this information. It's not practice-changing... yet, but certainly challenges the idea that every patient needs a beta blocker post-myocardial infarction (heart attack).
In reality, we are pushing more ACE-I than beta blockers on the discharge medications, but beta blockers are still on the list of required medications at the time of discharge to meet "quality of care" metrics. Maybe those metrics will get updated to be based on post-MI ejection fraction.
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You say these studies are old... isn't it also true that a lot of older medical trials were mainly done on (white) men?
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> You say these studies are old... isn't it also true that a lot of older medical trials were mainly done on (white) men?
To do them any other way might require diversity, equity and inclusion ... all big no-nos for the next 3.5 years. /s
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> ... beta blockers are still on the list of required medications at the time of discharge to meet "quality of care" metrics.
Adherence to bureaucratically-formulated "quality of care" is of course the standard for medical institutions because it absolves them of a lot of responsibility in the same way that cops can just say they were "following policy" to escape scrutiny after shooting someone. But it's not inspiring to me, a victim of a doctor's reckless medication choice that nearly cost me my life and which has left me with lingering issues for which I have zero recourse (nor even an apology). I am hardly an outlier.
The in
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I remember hearing, years ago, that the EU no longer recommends beta blockers as a first-line treatment for hypertension (high blood pressure) for a similar reason: They don't seem to do anything. Sure, they lower your blood pressure numbers, but (as I recall) the meta-study showed no appreciable difference in outcomes. That is, people who received beta blockers experienced the same number of heart attacks, strokes, and other hypertension-related problems as the group that didn't take them.
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> (I am a cardiologist)
> This is an interesting thing, and needs to be followed closely.
> There are a group of medications that have been made the standard of care for the treatment of a heart attack. These medications were tested in numerous high quality trials (randomized, double blind, placebo-control). But many of the trials are old.
So was the work of Galileo Galilei. That doesn't make it bad science.
The fact is that we have made quantum improvements in MI survival rates in the last 20 years. People with MI's in their 40's routinely survive cardiovascular events which would had killed them in the 1990's. A study like this is interesting, but mostly bullshit. One study doesn't prove anything and retro studies are notoriously flawed.
Results and Conclusions from the actual study. (Score:2)
If you look past the superficial summary and read the study (or at least skimmed it), some of the useful conclusions were that rose essential oil (the scent used) it's possible people liked or disliked it and that caused the grey matter increase.
the other thing to note was that only rose essential oil was tested, no other scents. so it's possible that other scents can do the same to stimulate the brain. with the understanding of the study, it's possible a hot new york restaurant dumpster in mid july m
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what the heck, i responded to this post:
https://science.slashdot.org/story/25/08/31/0621235/smelling-this-one-specific-scent-can-boost-the-brains-gray-matter
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You probably think Fox News is more reliable than a tabloid, don't you.
Lots of medications and procedures are guess work (Score:2)
A ton of medications and procedure have been shown to reduce signs of medical problems but have not been shown to extend life expectancy or quality of life.
Cholesterol medications are a prime example - they definitely reduce the bad cholesterol in your blood/raise the good stuff. But when I was younger at least, there were no studies showing increased life expectancy. For all we know they are reducing a symptom of the problem but not solving the problem itself.
The pharma industry actively harms people (Score:2)
[1]SSRIs and School Shootings, FDA Corruption, and Why Everyone on Anti-Depressants Is Totally Unhappy [rumble.com]
“Probably a fifth of the entire American population is on SSRIs. Psychiatrist Josef Witt-Doerring explains why that’s terrifying and dangerous.”
--
* About 15-20% of the U.S. population currently takes anti-depressants daily, a 500% increase since the early 1990s.
* Despite heavy prescribing of SSRIs, overall mental health outcomes have worsened, with rising suicide and disability rat
[1] https://rumble.com/v6y8kam-ssris-and-school-shootings-fda-corruption-and-why-everyone-on-anti-depressa.html?e9s=src_v1_ucp_v
Who knew this, and when did they know it? (Score:2)
You can bet money the drug makers have known this for a while but kept silent to protect profits.
Re: (Score:3)
Your tinfoil hat is a little too tight.
I am a cardiologist.
Beta blockers are cheap. We're talking ~5 dollars a month, with several options that are generic in most countries (including the US). This includes carvedilol and metoprolol succinate, the two most commonly prescribed beta blockers after a heart attack in the US and Europe. No drug company is getting rich off of them.
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> Beta blockers are cheap. ... No drug company is getting rich off of them.
I am NOT a cardiologist, nor even a doctor - but I'm a bit surprised the OP didn't know this. Beta blockers have been around for a long time, and (anecdotally) appear to be pretty commonly prescribed.
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As noted above, beta blockers are a $10 billion category: [1]https://www.databridgemarketre... [databridge...search.com]
[1] https://www.databridgemarketresearch.com/reports/global-beta-blockers-market
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Considering there are [1]tens of millions of people taking beta blockers [clincalc.com] - a daily drug - that's not actually a whole lot of money.
[1] https://clincalc.com/DrugStats/TC/BetaBlockersCardioselective
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It's ten billion dollars a year to someone . That is larger than entire industries.
"It's difficult to get a man to understand something when his salary depends on his not understanding it." (Apparently not Upton Sinclair, as many have asserted)
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Yeah that is crap and not true. Your average Beta-blocker RX is less than 40 cents... as a fact. It is so inexpensive that most companies will not even engage in that trade. Be thankful for India.
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Present the data like I did. Some guy on /. saying "that is crap" is unpersuasive.
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So your argument is that no one would chase smaller profits?
You may be a cardiologist, but you don't seem to be much of an economist or indeed a sociologist. According to this and other sources we're talking about a nearly 10 billion dollar market: [1]https://www.databridgemarketresearch.com/reports/global-beta-blockers-market [databridge...search.com]
That's way more than enough for people to do Bad Things.
[1] https://www.databridgemarketresearch.com/reports/global-beta-blockers-market
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I'm not much of an economist, but I know that since beta blockers have been generic for decades, there are a lot of players on the market. Profits on generic beta blockers are razor thin. It's not even a blip on the radar in terms of profits for any large pharmaceutical company.
As I said earlier, the price per month is somewhere between $4 and $10. You can't extract more than that in profits in a month. And if you try to extract more profits, the pharmacy will find a cheaper generic pharmaceutical company
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"A billion here, a billion there--pretty soon, you're talking real money."
According to [1]this study [usc.edu], about $18 of every $100 spent by consumers on generic drugs goes to the manufacturers' net margins. Moreover, a long chain of wholesalers, PBMs, pharmacies, etc. scoop up another $47 of net margins, all of which need volume to keep the lights on. So that's $1.8 billion to the manufacturers and another $4.7 billion to the middlemen (insurance aside). Again, you are not much of an economist if you didn't know
[1] https://schaeffer.usc.edu/research/flow-of-money-through-the-pharmaceutical-distribution-system/
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> "A billion here, a billion there--pretty soon, you're talking real money."
> According to [1]this study [usc.edu], about $18 of every $100 spent by consumers on generic drugs goes to the manufacturers' net margins. Moreover, a long chain of wholesalers, PBMs, pharmacies, etc. scoop up another $47 of net margins, all of which need volume to keep the lights on. So that's $1.8 billion to the manufacturers and another $4.7 billion to the middlemen (insurance aside). Again, you are not much of an economist if you didn't know this or try to verify it before posting. It took me about a minute to track this down.
> $10 billion is a pretty big drop in the bucket: the worldwide pharmaceutical market is $1.6 trillion, so beta blockers represent 0.625% or 1 in 160 dollars spent. That's a lot more than a rounding error.
The key phrase there " to keep the lights on ".
There's money in generics, and all the people involved in the supply line along the way, but the majority of that money is spent keeping the lights on.
They take a bit of profit, but if they take too much someone else just jumps in because that's how markets work.
Not to say they don't care about the market at all, but the generic manufacturers don't have a lot of sway.
If anything, the pharmas with actual influence might actually prefer that beta-blockers go away a
[1] https://schaeffer.usc.edu/research/flow-of-money-through-the-pharmaceutical-distribution-system/
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> The key phrase there "to keep the lights on".
Where the hell do you think those people's paychecks come from? It's not all paying for rent an illumination. I have a hard time believing you are arguing in good faith--maybe you're young and don't understand how things really work when people have mortgages and kids to feed?
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Oh, and I missed this:
> It can't be at $10 per month per patient. If it was, there would be 1 billion Americans on beta blockers.
$10 billion globally is what multiple sources say. If you have better data, present it like I did. Your arithmetic is bad since you need to divide by 12 to get monthly numbers.
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> As I said earlier, the price per month is somewhere between $4 and $10.
No it is much less than that. Metroprolol Succinate 50mg is about 6 dollars for a thousand tablets and PBMs pay about 40 cents... less than the vial and label.
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The global market for that drug is north of $6 billion ( [1]source [coherentma...sights.com]), which squares with a $10 billion overall market considering the market share for metroprolol succinate.
[1] https://www.coherentmarketinsights.com/market-insight/metoprolol-tartrate-market-5256
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Less than one dollar a month. Aside from that, this report needs to be taken with great skeptism. We have decades of studies on the benifits of Beta Blockers, especially in post-MI.