Hypertension associated w...

A 52-year-old man with a long-standing history of marginally controlled hypertension presents with gradually increasing shortness of breath and reduced exercise tolerance with pain in his calves that causes him to stop walking after one block. His medications include enalapril and metoprolol. His physical examination reveals a blood pressure of 140/90 mm Hg, a respiratory rate of 22 breaths/ min, heart rate of 88 beats/ min, bibasilar rales, and trace pitting oedema. Posterior tibial and dorsalis pedis pulses are 1+.