A 52-year-old African American man presents for a routine follow-up of his hypertension. He was started on lisinopril several years ago by a previous physician. He admits to taking his medication “most days.” He reports occasional, dull frontal headaches and nocturia twice nightly. He denies chest pain or palpitations but notes some shortness of breath when climbing two flights of stairs. His father had a stroke at age 60. He works a high-stress job as a financial analyst and frequently eats restaurant meals. He does not exercise regularly. He does not smoke but drinks 2-3 glasses of wine on weekends. There are no other significant past medical issues.