Clinical Research Directory

Inclusion Criteria: 1. Ambulatory adults age ≥60 years with HFpEF (EF ≥50% based on most recent transthoracic echocardiogram) 2. Hospitalized with HF in the past 24 months (defined by diagnostic codes in any position) 3. Taking any of the following ß-blockers: atenolol, bisoprolol, carvedilol, metoprolol succinate, or metoprolol tartrate (i.e., pharmacy prescription data) 4. Kaiser Permanence Northern California Membership Exclusion Criteria: 1. Alternative etiologies of HFpEF syndrome 2. Compelling guideline indication for ß-blocker: * Prior EF \<50% (i.e., based on the structured data field on transthoracic echocardiogram) * Current anginal symptoms (i.e., based on the Rose Angina single-question screener for angina) * MI (i.e., diagnostic codes) and/or coronary revascularization (i.e., procedure codes) within 3 years * Hospitalization for a primary discharge diagnosis of atrial fibrillation or atrial flutter in the prior 12 months * Other documented reason in the opinion of the treating provider and/or enrolling clinician-investigator 3. Evidence of recent decompensated HF * Hospitalization for a primary discharge diagnosis of HF within the past 30 days * Change in loop diuretic pharmacy prescription in the past 30 days (i.e. pharmacy prescription data) (Note: This definition is based on documented prescription changes and does not include short-term dose adjustments that were verbally communicated to the patient by their provider.) 4. Estimated life expectancy \<6 months (i.e., diagnostic codes) 5. Diagnosed dementia (i.e.., diagnostic codes) 6. Unable to provide informed consent 7. Loss of Kaiser Permanence Northern California Membership