Overview
- A randomized study in the New England Journal of Medicine, published Monday and presented at ACC.26, found that stable adults at least one year after a heart attack could stop beta-blockers without higher rates of death, another heart attack, or heart-failure hospitalization.
- The trial enrolled 2,540 patients at 26 sites in South Korea and, over a median 3 to 3.5 years, recorded the primary outcome in 7.2% who discontinued the drugs versus 9.0% who continued them, meeting non-inferiority.
- The findings apply to carefully selected patients without heart failure or weakened heart pumping, and the authors caution that the results may not extend to higher-risk groups or those who used beta-blockers for less than a year.
- People who stopped the drugs had small rises in heart rate and blood pressure, yet average systolic pressure stayed under 130 mmHg, and secondary measures such as new atrial fibrillation, heart function, quality of life, and serious adverse events were similar between groups.
- Experts say the study could shift care toward shared decisions to de‑escalate therapy in some patients, which may ease side effects and costs, though the single-country, mostly male sample (87% men) means more research is needed to confirm the results elsewhere.