Beta-blockers: One year of treatment may be enough after heart attack

Beta-blockers may not be necessary for all people after a heart attack, according to new research. Catherine Falls Commercial/Getty Images This article originally appeared on Medical News Today Having a heart attack can raise a person’s risk for other cardiovascular conditions.

Following a heart attack, doctors typically prescribe a combination of therapies, including medications like beta-blockers. A new study found that people who have had a heart attack, but who are considered low risk for other cardiovascular complications, may be able to safely discontinue beta-blocker use after at least one year.

Researchers estimate that over 17.9 million people globally die each year from cardiovascular diseases, such as myocardial infarction , also known as a heart attack. Having a heart attack can increase a person’s risk for having other cardiovascular issues, including another heart attack , heart failure , arrhythmia , stroke , and peripheral artery disease .

To help lower your risk for these heart conditions, after a heart attack doctors normally prescribe a combination of lifestyle changes, such as eating a heart-healthy diet and quitting smoking , along with cardiac rehabilitation and certain medications , such as beta-blockers . Now, a new study presented at the American College of Cardiology’s Annual Scientific Session (ACC.26) reports that people who have had a heart attack, but who are considered low risk for other cardiovascular complications, may be able to safely discontinue beta-blocker use after at least one year.

The results of the study were also published in The New England Journal of Medicine . Continuing beta-blockers may not be needed in low-risk patients For this study, researchers analyzed medical data from more than 2,500 participants with an average age of 63 in South Korea who, between 2021 and 2024, had no additional cardiac issues after taking beta-blockers for at least one year following a heart attack.

Beta-blockers are a type of medication that help reduce heart rate and blood pressure by lowering the effects of stress hormones like epinephrine (adrenaline) on the body’s beta receptors . This can help improve blood flow and help manage future heart attacks, angina , and heart failure .

At the study’s conclusion, researchers found that after a median of 3.1 years of follow-up, the study’s primary endpoint — including all-cause death, recurrent heart attack, or heart failure hospitalization — occurred in 7.2% of study participants who stopped taking beta-blockers, compared to 9% in those who continued to take them. “In appropriately selected patients who survived a heart attack and do not have heart failure or left ventricular systolic dysfunction , routine continuation of beta-blockers indefinitely may not be necessary,” Joo-Yong Hahn , MD, a cardiologist at Samsung Medical Center in South Korea, and senior author of this study, said in a press release .

“In practice, for stable patients who are several years out from a heart attack, discontinuation can be considered through shared decision-making and with monitoring of blood pressure and heart rate,” he said. Challenging a decades-long heart attack treatment practice Medical News Today spoke with Cheng-Han Chen, MD , a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study.

“Beta-blockers have been for decades a mainstay of medical therapy for patients who suffer a heart attack,” Chen commented. “These study results add to more recent research that beta-blockers may be less necessary in today’s age of newer and more efficacious medications and certainly make me re-examine their necessity in my patients who take them.” “Future research should examine whether these findings apply in a more diverse population and determine the categories of patients who may still benefit from beta-blocker therapy,” he added.

MNT also spoke with Craig Basman, MD , a cardiologist at Hackensack University Medical Center, who commented that this study is an important and welcome piece of research because it challenges a practice that has been in place for decades. “It reinforces the direction we’ve been moving in cardiology: using evidence-based therapy to guide management,” Basman explained.

“It’s not a green light for everyone to stop their medication, but it does open the door for a new conversation with the right patients about what is truly necessary for their long-term health.” Why would people want to stop using beta-blockers? For people who have experienced a heart attack and are on beta-blockers, the benefits of discontinuing them, for the appropriate patient, are primarily about improving their quality of life, Basman said.

“While these drugs are important treatments for many conditions, they can have side effects for some individuals, such as fatigue, dizziness, depression, or exercise intolerance,” he detailed. “Being able to safely stop a medication means potentially alleviating these side effects, which can make a big difference in a person’s daily energy and well-being.

It also reduces the number of pills a patient needs to take every day, which can be a significant relief.” Rigved Tadwalkar, MD, FACC , consultative cardiologist and director of Digital Transformation Pacific Heart Institute in Santa Monica, CA, agreed. “Beta-blockers are very effective medications, but they’re not always easy to live with long term.

Many patients experience fatigue, reduced exercise tolerance, dizziness, sexual dysfunction , or just a general sense of being ‘slowed down.’ For someone who has otherwise recovered well and is trying to get back to a normal, active life, those side effects can be limiting.” — Rigved Tadwalkar, MD, FACC “There’s also a broader principle here around minimizing unnecessary long-term therapy,” Tadwalkar continued. “Every medication adds complexity, including a greater potential for interactions or side effects over time.

In patients who no longer have a clear ongoing indication, in this case no heart failure, no ongoing angina or arrhythmia, being able to step back from a medication is good cardiology practice,” he explained. “The next step (for this research) is really about confirming and extending these findings across broader patient populations,” Tadwalkar added.

“This was a well-done study, but it was conducted in a relatively specific group of patients, so it will be important to see similar results reproduced in more diverse populations, including more women and patients from different healthcare systems. That helps ensure the findings apply widely in everyday clinical practice.”