Cardiorenal Risk Reduction in Hypertension with Advanced-Stage Nephropathy

A 56-year-old Black man comes in with blood pressure (BP) 162/96 mm Hg, heart rate 78 bpm, estimated glomerular filtration rate 49 mL/min, potassium 4.2 mEq/L, and albuminuria 165 mg/g with no history of diabetes mellitus or cardiovascular disease on amlodipine 10 mg, hydrochlorothiazide (HCTZ) 12.5 mg, and olmesartan 40 mg.

Which one of the following would be most likely to reduce his BP closer to the goal of 130/80 mm Hg?

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