REBOOT Trial 2025: Time to Rethink Beta-Blockers?
Lisa Mathis FNP-BC
New Guidelines that will make your Heart “Skip a Beat”
Lisa Mathis FNP-BC
The newest results from the REBOOT Trial 2025 are sure to give some healthcare providers pause. For the past 40 years, prescribing beta-blockers has been the standard of care for patients post-myocardial infarction (MI) and for managing tachyarrhythmias. However, this new research challenges that long-standing approach — especially in women.
The REBOOT trial found no additional benefit from beta-blocker use in post-MI patients, and more notably, it showed a higher risk of death, heart attack, and hospitalization for heart failure in women. These findings are expected to spark significant changes in treatment guidelines worldwide, prompting calls for a sex-specific approach to beta-blocker therapy.¹
This is a massive shift from decades of established practice — and it's likely to stir up controversy in the medical community. After all, beta-blockers have been a cornerstone of cardiac care for nearly half a century.
Patients will understandably have questions:
These questions will come quickly once the study becomes more widely known to the public.
As advanced care providers, we have a unique responsibility: to educate, support, and guide our patients through confusing or distressing updates like this one.
✔️ Reassure patients — they should not stop beta-blockers abruptly, especially if prescribed by their cardiologist.
✔️ Take time to explain the new findings, including that not all patients will be affected the same way.
✔️ Reach out to cardiologists to coordinate care and share any patient concerns.
✔️ Use shared decision-making to guide conversations around continuing, tapering, or changing medications
While the REBOOT trial observed higher event rates in women and in patients with STEMI on beta-blockers versus those not on them, the investigators urge caution in interpreting these findings. They describe the results as “hypothesis-generating,” not definitive.² In other words, more research is needed before sweeping changes are made — but the signal is significant enough that re-evaluation is warranted.
It’s likely that some female patients will feel alarmed by this study, especially those already managing heart conditions. That’s why patient education is absolutely critical. Beta-blockers still have an important role in many treatment plans. This study shouldn’t be used to discourage their use altogether — rather, it reminds us to approach prescribing with nuance, especially when it comes to sex-specific outcomes.
Beta blockers are a type of medication that reduce the workload on the heart and help it beat more regularly. They block the effects of the hormone epinephrine (adrenaline) on the heart and blood vessels.
Beta blockers are used to treat: Hypertension, arrhythmias, heart failure, and chest pain. Beta blockers slow the heart rate and reduce blood pressure by blocking beta receptors in the heart, lowering the force of heart muscle contractions and helping blood vessels relax and open up. Side effects may be fatigue or tiredness, cold hands and feet, dizziness or lightheadedness and bradycardia, along with bronchospasm in the asthma patient.
So, we must keep in mind once again that education is the most imperative. Beta blockers are generally safe and effective medications when taken as prescribed, but like all medications, they come with important precautions. Understanding how to use them safely can help reduce side effects and avoid complications.
"Education is what survives when what has been learned has been forgotten" — Albert Einstein.
1-citechdaily.com/after-40-years-heart-doctors-say-beta-blockers-may-do-more-harm-thangood/#:~:text=Results%20show%20women%20treated%20with,when%20treated%20with%20beta-blockers.
2-https://www.acc.org/latest-in-cardiology/articles/2025/08/26/11/47/sat-520am-bb-esc-2025