LIVEBETTER: A Trial Comparing Medications in Older Adults With Stable Angina and Multiple Chronic Conditions

Eligibility Criteria

• * Age ≥70 years; ≥65 years for underrepresented minorities (URM) of black race or Hispanic ethnicity
• * ≥ 2 Multiple Chronic Conditions as defined by Centers for Medicare and Medicaid Services (CMS)
• * Diagnosis of Symptomatic Stable Ischemic Heart Disease with plans to initiate medical therapy identified by at least one of the following:
• 1. positive non-invasive functional or anatomic testing suggestive of obstructive coronary artery disease
• 2. coronary angiography with stenosis ≥70% in a coronary artery ≥2 mm in diameter or
• 3. Invasive coronary angiography with positive physiologic testing in at least one vessel (FFR ≤ 0.80 or iFR ≤0.89)
• * Age ≥ 18 years
• * Identified as caregiver of LIVEBETTER participant
• * Current taking beta-blocker or calcium channel blocker\*
• * Contraindication to beta-blockers or calcium channel blockers including:
• 1. significant hypotension
• 2. high grade AV block
• 3. severe symptomatic bradycardia
• 4. severe obstructive lung disease
• * Documented intolerance to beta-blockers or calcium channel blockers
• * Probable or definite high-risk coronary artery disease including unrevascularized left main disease and/or unrevascularized multi-vessel disease including the proximal left anterior descending (LAD) artery with plans for immediate complete revascularization
• * Plans for complete revascularization within 2 weeks
• * Clear indication for beta-blockers or calcium channel blockers including:
• 1. Diagnosis of acute coronary syndrome (ACS) with reduced ejection fraction within past year
• 2. Heart failure with reduced ejection fraction (HFrEF) within past year
• * Actively participating in another clinical trial involving an investigational medication or device
• * Primary language other than English or Spanish
• * Inability to complete follow-up (e.g. life expectancy \<12 months, impaired decision-making determined by validated instrument)
• * Previously enrolled in LIVEBETTER
• * Refused informed consent
• * Professional caregiver (i.e. not a relative or close friend of the participant)
• * Primary language other than English or Spanish
• * Inability to complete follow-up
• * Previously enrolled in LIVEBETTER
• * Refused informed consent