Race/Ethnicity Considerations for Blood Pressure Management: A 58-Year-Old Man with Newly Diagnosed Stage 2 Hypertension

A 58-year-old Black man was referred to the preventive cardiology clinic for a new diagnosis of essential hypertension. He has no other medical history. He was found to have blood pressure (BP) 142/93 mm Hg during a routine employer-based health screening at his software company. He reports feeling well overall and exercises four times a week at a moderate intensity. His father experienced a myocardial infarction at 54 years of age.

On physical examination, his BP is 145/90 mm Hg when measured using an appropriately positioned upper arm cuff of the correct size after he sat quietly for 5 min with his back supported and both feet on the ground. The remainder of his examination is within normal limits. Further laboratory testing reveals normal renal function and electrolytes. His 10-year risk of atherosclerotic cardiovascular disease (ASCVD) according to the pooled cohort equations is estimated at 10.3%.

Which one of the following is the best approach to manage his BP?

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