Reference no: EM133585148

Question

A 48-year-old Caucasian man presents to the clinic to establish care after moving to the area. He has no significant past medical history and has not seen a physician in over 10 years. He takes no medications and denies having any allergies. He has been a smoker for the past 20 years and smokes approximately half a pack daily. His brother and father have diabetes; his brother is treated with metformin, whereas, his father requires insulin. His father has experienced two strokes. He is obese, with a body mass index of 34 kg/m2. On physical examination, his blood pressure is 170/90 mm Hg in the left arm and 168/89 mm Hg in the right arm. The patient is instructed to follow a low-salt diet, quit smoking, perform daily exercise, and diet to lose weight. He returns several weeks later for a follow-up appointment. The patient reports a 1.8 kg (4 lb) weight loss. His blood pressure on presentation is 155/94 mm Hg in both arms. What is the most appropriate next step in management? A 48-year-old Caucasian man presents to the clinic to establish care after moving to the area. He has no significant past medical history and has not