Q. You are seeing a patient for follow-up today in your clinic. He is a 54-year-old male with a long-standing history of uncontrolled hypertension despite a multi-drug regimen. Though you have counseled him frequently over the years, he continues to smoke 1 pack of cigarettes per day and consumes 4 to 5 drinks every evening. He has a strong family history of diabetes, and his father died at 61-years-old of heart disease. The current medications listed in his chart are lisinopril 20 mg once daily, hydrochlorothiazide 25 mg once daily, and atorvastatin 40 mg in the evenings. His only complaint today is lethargy, and he reports “feeling tired all the time”. On physical examination, he is 167 cm (5 ft 6 in) tall and weighs 113 kg (250 lb); BMI is 40 kg/m2. His blood pressure is 139/89 mm Hg, heart rate 70/min, and respiratory rate 16/min. Which of the following is an appropriate next step in the management of this patient?