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J.J. a 55-year-old white male, has come in for his annual physical. He has hypertension and type 2 diabetes mellitus (type 2 DM). His blood pressure (BP) is controlled with lisinopril 20 mg daily and amlodipine 5 mg daily (BP 132/82 mm Hg). His most recent hemoglobin A1c was 7.2% while taking metformin. His father died at age 55 of a myocardial infarction, and his brother, age 57, just underwent angioplasty. J.J. eats fast food at least five times a week because of his work schedule. He weighs 245 lb and stands 5 feet 11 inches. His total cholesterol is 237 (low-density lipoprotein [LDL], 190; high-density lipoprotein [HDL], 35; triglycerides, 200).
1. What would you consider first-line pharmacological treatment for the patient and why? Please write the order for the treatment as a prescription. Please provide rationale for your choice of treatment.
2. List one or two adverse effects to the therapy you recommended in question #1.
3. Are there any adverse effects that would cause you to change therapy, if so, please explain?
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