595 Chronic Illness

A 64-year-old Black male with a history of hypertension presents to your clinic for complaints of headaches and blurry vision x 2 days. He denies any weakness, numbness, chest pain, shortness of breath, palpitations, or recent, illicit drug use. He states he has been compliant with his medications (hydrochlorothiazide 12.5 mg and metoprolol 50 mg BID), and he took his meds this morning. Recent labs from 3 weeks ago indicate no diabetes. He has no other medical history.

His vitals include: B/P 195/115, P- 90, T- 98.9, R- 20. 

Recent labs (3 weeks prior):

Total Cholesterol – 263 mg/dl
LDL-192 mg/dl
HDL- 35 mg/dl
Trig- 180 mg/dl

He did not return for these results and did not start any new meds.
Discuss your differentials and the most likely diagnosis and plan of care for this patient, including his ASCVD risk, specific goals, medications, referrals, and follow-up. Remember to include your rationales. Support your work with primary and secondary references, such as clinical practice guidelines, do not use point-of-care references. 

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