Role of Intensive Lifestyle Therapy in Primary Prevention in a 40-Year-Old With Hypertriglyceridemia
A 40-year-old male with dyslipidemia and family history of premature coronary artery disease (CAD), he presents to clinic concerned about his personal risk for CAD. In the last five years, he reports gaining about 30 pounds and reports less exercise tolerance. On exam, his blood pressure is 118/84, pulse 82, weight 199.8 pounds, height 5 feet 9 inches, BMI 29.5 and waist circumference is 41.5 inches. His fasting glucose is 103, A1c is 5.8, total cholesterol is 235, LDL 125, HDL 26, and Triglycerides 439. Given the decreased exercise tolerance a treadmill stress test was ordered, which did not show any evidence of ischemia.
What is the first step in his management?