Borderline high blood pressure

A 47-year-old man presents to your office for a follow-up visit. He vaguely remembers being told that he had Borderline high blood pressure at some point in the past. He was seen 3 weeks ago for an upper respiratory infection and was noted to have a BP of 164/98.

He tells you he feels great, does not smoke and only has a couple of beers on the weekend.  He admits that he does not exercise regularly and his job requires him to sit at a desk all day.

You ask about his family history, and he tells you that his father died of a stroke at the age of 69 years old.  His mother is alive and in good health at the age of 72.  He has two siblings and as far as he knows, they are healthy.

You start by taking his BP.  His BP is 156/96 in his left arm and 152/98 in his right arm.  He is afebrile, AP=78, resp= 14.  A quick listen to his lungs and heart reveal no clinically significant findings. You look in his chart and note he is 70 inches tall and weights 210 lbs.

1. What are two “red flags” in this case and explain why so.  Support your answer.

2. What labs would you order and what would you be looking for in each?

3. Name three non-pharmacological interventions you would recommend and why?